Morphological characteristics and outcomes of aortic repair of acute type A aortic dissection occurring in patients with aortic arch branching variants.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-03-01 Epub Date: 2024-09-25 DOI:10.1007/s00595-024-02919-6

Takahiro Yamamoto, Naoyuki Kimura, Daijiro Hori, Makiko Mieno, Manabu Shiraishi, Homare Okamura, Koji Kawahito, Atsushi Yamaguchi

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引用次数: 0

Abstract

Purpose: To investigate the morphological characteristics and operative outcomes of acute type A aortic dissection (ATAAD) in patients with aortic arch variants.

Methods: Of 616 patients with ATAAD, 97 (15.7%) had aortic arch variants, including bovine aortic arch (BAA, n = 66), isolated left vertebral artery (ILVA, n = 25), and aberrant subclavian artery (ASA, n = 6). The characteristics and outcomes were compared between the normal branching group (control, n = 519) and the total/individual arch variant groups.

Results: Compared to the control group, arch entry was more prevalent in the BAA (18.5% vs. 31.8%) and ILVA groups (44%) (both, P < 0.05), and right common carotid arterial occlusion was less common in the arch variant group (6.7% vs. 0%, P = 0.017). The in-hospital mortality (9.2% vs. 9.3%), new-onset stroke (7.3% vs. 7.2%), and 5-year survival (81.7% vs. 78.8%) did not differ markedly between the control and arch variant groups. Arch repair was performed in 28.9% (28/97) of the arch variant group using 3-4 vessel antegrade cerebral perfusion, with 3.8% in-hospital mortality and a 15.4% stroke rate, which were comparable to those of the control group.

Conclusions: Aortic arch variants may influence tear location and involvement of the supra-arch vessels but may not affect postoperative outcomes.

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主动脉弓分支变异患者发生急性 A 型主动脉夹层的形态特征和主动脉修复的结果。

目的：研究主动脉弓变异型患者急性A型主动脉夹层（ATAAD）的形态特征和手术效果：在616例ATAAD患者中，97例（15.7%）有主动脉弓变异，包括牛主动脉弓（BAA，n = 66）、孤立左椎动脉（ILVA，n = 25）和锁骨下动脉异常（ASA，n = 6）。比较了正常分支组（对照组，n = 519）和总/单个弓变异组的特征和结果：结果：与对照组相比，BAA 组（18.5% 对 31.8%）和 ILVA 组（44%）的弓入口发生率更高（均为 P 结论：主动脉弓变异可能会影响主动脉瓣的功能：主动脉弓变异可能会影响撕裂位置和弓上血管受累情况，但可能不会影响术后结果。

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

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.