DeBakey I型主动脉夹层紧急手术后的远端事件。

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Shunsuke Miyahara, Gaku Uchino, Yoshukatsu Nomura, Hiroshi Tanaka, Hirohisa Murakami
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引用次数: 0

摘要

研究目的本研究旨在探讨急性德巴克I型主动脉夹层(AIAD)手术治疗后的早期和中期效果,以及主动脉弓置换术的范围对总体存活率和预防远端主动脉事件的影响:2002年3月至2020年7月期间,共对374例AIAD主动脉修复术进行了回顾性研究。154名患者(41.2%)进行了全弓置换术(TAR),220名患者(58.8%)进行了半弓或部分弓置换术(PAR):结果:手术死亡率无明显差异(PAR为7.7%,TAR为13.0%,P = 0.096)。5年存活率无差异(TAR为77.8%,PAR为72.6%,P = 0.14)。各组的再手术和再干预以及远端主动脉复合事件发生率相当(p=0.21、0.84 和 0.91)。治疗加权调整模型的逆证明性显示,TAR 组的 5 年免再手术率和主动脉事件发生率更高(p 分别为 0.029 和 0.054):拱门置换的范围是根据患者的背景决定的,因此很难比较两种手术方法的优劣。不过,对于经过适当选择的患者,TAR 可在长期内避免主动脉事件的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distal Events Following Emergent Operation for DeBakey Type I Aortic Dissection.

Objective: The goal of this study is to examine early and Mid-term results after surgical treatment of acute DeBakey type I aortic dissection (AIAD) and the effect of the range of aortic arch replacement on overall survival and prevention of distal aortic events.

Methods: Between March 2002 and July 2020, a total of 374 AIAD aortic repairs were reviewed. One hundred fifty-four (41.2%) patients had total arch replacement (TAR), while 220 (58.8%) had hemi- or partial arch replacement (PAR).

Results: Operative mortality did not show a significant difference (7.7% in PAR, 13.0 % in TAR, p = 0.096). Survival at 5 years showed no difference (77.8% in TAR, 72.6% in PAR, p = 0.14). Freedom from reoperations and re-interventions, as well as composite aortic events in the distal aorta, were comparable across groups (p=0.21, 0.84, and 0.91, respectively). The inverse provability of treatment weighting-adjusted model displayed higher 5-year freedom from reoperations and aortic events in the TAR group (p = 0.029 and 0.054, respectively) Conclusion: The extent of Arch replacement is determined based on the patient's background, making it difficult to compare the superiority of both surgical methods. However, TAR for appropriately selected patients may provide the benefit of avoiding aortic events in the long-term.

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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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