胸腹主动脉瘤修复:单中心经验

U. Aydin, Z. Duman, Emre Yasar, Muhammed Bayram, Sefa Eltutan, Ersin Kadiroğulları, Onur Şen
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摘要

目的:胸腹主动脉瘤(TAAA)的金标准修复仍是开放性手术。然而,很少有心血管中心在TAAA修复方面有经验。本研究的目的是研究由一个外科团队发起的开放式TAAA修复计划的方法和四年的结果。材料与方法:在本回顾性队列中,收集了2018年8月至2022年3月期间因TAAA手术的患者。排除采用血管内入路治疗的患者。排除后,19例患者纳入我们的分析。术后结果包括住院死亡率、脊髓缺损、主要神经系统并发症、透析需求和内脏缺血。结果:10例(52.6%)患者行Crawford II级TAAA修复,5例(26.3%)患者行Crawford III级TAAA修复,4例(21.1%)患者行Crawford IV级TAAA修复。住院死亡6例(31.6%)。死亡原因为围手术期心肌梗死2例(10.5%),内脏缺血1例(5.3%),多系统脏器功能衰竭3例(15.8%)。致死率最高的是克劳福德区修复,为50.0%。2例(10.5%)患者出现脊髓缺损。结论:胸腹主动脉瘤手术死亡率高。应支持三级血管中心的开放性胸腹主动脉瘤修复方案,以提高胸腹主动脉瘤修复的手术效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thoracoabdominal aortic aneurysm repair: A Single center experience
Aim: The gold standard repair of thoracoabdominal aortic aneurysm (TAAA) is still open surgery. However, few cardiovascular centers are experienced in TAAA repair. The aim of this study was to examine the methods and four-year outcomes of the open TAAA repair program initiated by a single surgical team. Material and Methods: In this retrospective cohort, patients who were operated for TAAA between August 2018 and March 2022 were collected. Patients treated with the endovascular approach were excluded. After exclusion, 19 patients were included in our analysis. As postoperative outcomes, in-hospital mortality, spinal cord deficit, major neurologic complications, need for dialysis, and visceral ischemia were collected. Results: Crawford extent II TAAA repair was performed in 10 (52.6%) patients, Crawford extent III in 5 (26.3%) patients, and Crawford extent IV in 4 (21.1%) patients. In hospital mortality occurred in 6 (31.6%) patients. The causes of mortality were perioperative myocardial infarction in 2 (10.5%) patients, visceral ischemia in 1 (5.3%) patient, multisystem organ failure in 3 (15.8%) patients. The highest mortality rate (50.0%) occurred in Crawford extent II repair. Spinal cord deficit developed in 2 (10.5%) patients. Conclusion: Thoracoabdominal aortic aneurysm surgery is associated with high mortality rates. Open thoracoabdominal aortic aneurysm repair programs in tertiary vascular centers should be supported, to improve the surgical results of thoracoabdominal aortic aneurysm repair.
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