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基于上升大动脉的跨胸大血管重建的结果

Joel Robert Hlavaty¹, Anand Kathardekar¹, Jane M Chung¹

¹Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, Harrington Heart & Vascular Institute, University Hospitals, Cleveland, OH, USA.

Annals of vascular surgery

|February 18, 2026

概括

基于上升大动脉的大血管重建 (AA-TGVR) 对复杂的大血管封闭性疾病 (GVOD) 和区域0 TEVAR准备是安全有效的. 结果包括低30天死亡率和重新干预率.

科学领域:

心血管外科心血管外科
血管外科血管外科
胸部外科手术胸部外科手术

背景情况:

在目前的内血管时代,以上升大动脉为基础的跨胸大血管重建 (AA-TGVR) 是一种不常见的程序.
对于涉及门或多个血管的广泛,状大血管封闭性疾病 (GVOD) 至关重要.
此外,AA-TGVR还适用于需要0区胸部内血管修复 (TEVAR) 的患者.

研究的目的:

评估AA-TGVR的单中心结果.
评估AA-TGVR对特定复杂血管病理的安全性和有效性.
确定与AA-TGVR相关的手术成功率和并发症率.

主要方法:

对从2015年1月1日至2025年3月1日接受AA-TGVR患者的回顾性审查.
排除A型大动脉剖析和大血管再植入的患者.
主要结局:30天死亡率;次要结局:30天和晚期中风,重新干预和死亡率.

主要成果:

包括24名患者,11名非遮蔽 (45.8%),13名GVOD (54.2%). 平均年龄68.2岁,70.8%是女性.
进行了50次绕道移植;在45.8%的患者中使用了体外循环支持 (ECS).
30天死亡率:4.2%;30天中风/重新干预:4.2%. 晚期中风:4.2%;晚期死亡率:17.4%;6次晚期重新干预.

结论:

AA-TGVR是复杂的闭塞性和非闭塞性大血管疾病的安全和有效选择,不适合内血管修复.
这也是一种可行的方法,用于0区TEVAR准备.
身体外循环支持 (ECS) 可以通过提供前级大脑输液来减轻脑缺血风险.

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