逆行上升大动脉剖析内血管治疗的长期结果
Gui-Yan Peng1, Mian Wang1, Chen Yao1
1Department of Vascular Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
概括
胸内血管大动脉修复 (T-EVAR) 在逆行上升大动脉剖析 (rAAD) 中显示出有希望的长期结果. 这种内血管方法可能是选择性患者开放修复的可行替代方案.
科学领域:
- 心血管外科心血管外科
- 血管内干预 血管内干预
- 大动脉疾病管理管理
背景情况:
- 逆行上升大动脉剖析 (rAAD) 治疗仍在争论中.
- 内血管修复提供了一种不那么侵入性的方法.
- 长期结果和血液动力学效应需要进一步研究.
研究的目的:
- 评估对rAAD的内血管治疗的长期临床结果.
- 分析T-EVAR后上升大动脉的血液动力学改造.
- 评估T-EVAR作为开放式维修的潜在替代方案.
主要方法:
- 对接受T-EVAR治疗的RAAD患者进行了回顾性单中心研究 (2001-2020年).
- 临床数据分析侧重于大动脉相关死亡和再干预.
- 计算流体动力学 (CFD) 用于评估血液动力学变化.
主要成果:
- 85名患者接受了T-EVAR,技术成功率为86%,住院死亡率为1%.
- 随访75个月的中位数显示7%的全因死亡率和88.6%的10年生存率.
- 在上升的大动脉中观察到,真光径的显著增加和墙壁剪切应力的减少.
结论:
- 对于rAAD,T-EVAR显示出令人鼓舞的短期和长期结果.
- 该程序导致上升大动脉的有利血液动力学变化.
- 对于选定的rAAD患者来说,T-EVAR可能是一个合适的治疗选择.
相关概念视频
Aortic Regurgitation I: Introduction
1.7K
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.7K
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
1.2K
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
1.2K
Aortic Regurgitation III: Medical Management
599
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
599
Aneurysm II: Clinical Manifestations and Diagnostic Studies
593
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
593
Aneurysm III: Interprofessional Care
479
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
479
Aneurysm IV: Nursing Management
627
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
627


