Aortic Pseudoaneurysm After Type A Aortic Dissection: Results of Conservative Management

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery Pub Date : 2023-09-01 DOI:10.1053/j.semtcvs.2022.04.004

German J. Chaud MD, Siamak Mohammadi MD, Manuel Roque Cervetti MD, Samantha Guimaron MD, Alexandre Sebestyen MD, François Dagenais MD, Eric Dumont MD

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引用次数: 2

Abstract

Aortic pseudoaneurysms after acute Type A aortic dissection (ATAAD) repair have been reported as high as 10 - 24 % and surgical treatment is usually recommended. The objective of this article is to examine the safety and efficacy of a conservative approach to aortic pseudoaneurysm and to compare this approach to standard surgical treatment. We retrospectively examined 39 patients who had an aortic pseudoaneurysm after ATAAD surgery in order to examine outcomes (baseline characteristics, presentation and freedom from aortic events and mortality). We initially identified 31 patients treated conservatively (CT). After close follow up, 5 of them were operated so 13 patients were treated surgically (ST) and analyzed at a long-term follow-up while 26 were in the conservative group. Mean follow - up of the whole cohort was 7.9 ± 5.9 years. The freedom from aortic-related mortality at 1, 5 and 10 years was 100 %, 83. 3 % and 72. 9 % for the ST group and 95. 8%, 77. 3 % and 77.3 % for the CT group (P= 0.35). A conservative approach to aortic pseudoaneurysms could be justified in asymptomatic patients. A close follow-up by a dedicated aortic clinic is mandatory so that patients are referred for surgery when necessary.

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A型主动脉夹层术后主动脉假性动脉瘤的保守治疗结果

据报道，急性A型主动脉夹层（ATAAD）修复后的主动脉假性动脉瘤高达10-24%，通常建议手术治疗。本文的目的是检查主动脉假性动脉瘤保守治疗的安全性和有效性，并将这种方法与标准手术治疗进行比较。我们回顾性检查了39名ATAAD手术后发生主动脉假性动脉瘤的患者，以检查结果（基线特征、表现、无主动脉事件和死亡率）。我们最初确定了31名接受保守治疗（CT）的患者。在密切随访后，其中5例进行了手术，因此13名患者接受了手术治疗（ST），并在长期随访中进行了分析，而26名患者属于保守组。整个队列的平均随访时间为7.9±5.9年。ST组在1年、5年和10年时主动脉相关死亡率分别为100%、83.3%和72.9%，CT组分别为95.8%、77.3%和77.3%（P=0.035）。无症状患者可采用保守治疗主动脉假性动脉瘤。必须由专门的主动脉诊所进行密切随访，以便在必要时将患者转诊进行手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.80

自引率

0.00%

发文量

324

审稿时长

12 days

期刊介绍： Seminars in Thoracic and Cardiovascular Surgery is devoted to providing a forum for cardiothoracic surgeons to disseminate and discuss important new information and to gain insight into unresolved areas of question in the specialty. Each issue presents readers with a selection of original peer-reviewed articles accompanied by editorial commentary from specialists in the field. In addition, readers are offered valuable invited articles: State of Views editorials and Current Readings highlighting the latest contributions on central or controversial issues. Another prized feature is expert roundtable discussions in which experts debate critical questions for cardiothoracic treatment and care. Seminars is an invitation-only publication that receives original submissions transferred ONLY from its sister publication, The Journal of Thoracic and Cardiovascular Surgery. As we continue to expand the reach of the Journal, we will explore the possibility of accepting unsolicited manuscripts in the future.