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大卫与本塔尔手术对于急性甲型大动脉解剖的治疗方法

Fausto Biancari¹, Giorgio Mastroiacovo¹, Mauro Rinaldi²

¹Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.

Journal of cardiovascular development and disease

|November 26, 2024

概括

大卫手术和本塔尔手术为A型大动脉解剖 (TAAD) 提供了持久的治疗方法. 戴维手术可能是急性TAAD的首选,如果可行,由经验丰富的外科医生进行.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
大动脉外科手术

背景情况:

甲型大动脉解剖 (TAAD) 是一种危急的情况,需要快速诊断和手术干预.
当TAAD影响主动脉根时,手术选择包括主动脉节约或本塔尔手术.

研究的目的:

为了比较本塔尔手术与大卫手术的结果,用于涉及大动脉根的A型大动脉剖析.
评估这些手术技术在大量患者队列中的耐用性和安全性.

主要方法:

分析了来自欧洲A型大动脉剖析注册表 (ERTAAD) 的3735名患者.
倾向性得分匹配被用来创建比较的组Bentall和大卫程序.
多层混合效应物流回归被认为是医院集群效应.

主要成果:

在倾向性得分匹配后 (每组115名患者),没有观察到术后结果的显著差异,除了本塔尔组的透析率更高.
大卫手术显示,在没有匹配的队列中,10年死亡率下降的趋势,但在匹配后,这种差异消失了.
在10年后,即使在匹配后,两种手术之间也没有发现近端大动脉重新手术率的显著差异.

结论:

戴维和本塔尔手术都是对涉及大动脉根的TAAD进行持久和有效的外科治疗.
在技术上可行的情况下,建议对急性TAAD进行大卫手术,并且由于其耐用性,经验丰富的外科医生可以进行.

关键词:

这是本塔尔程序.戴维程序是大卫程序.动脉动脉根的动脉动脉根.一种类型的甲动脉剖析.

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