The Journal of thoracic and cardiovascular surgery · 2024
Long-term outcomes in total arch replacement combined with frozen elephant trunk for acute type A aortic dissection.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Zhang Kai, Qiu Juntao, Wu Jinlin, Zhou Chenyu, Ji Yumeng, Xie Enzehua, Gao Shiqi, Hou Bin, Li Han, Chang Qian, Qian Xiangyang, Sun Xiaogang, Yu Cuntao
Аннотация
OBJECTIVE: The optimal surgical approach for acute type A aortic dissection involving the aortic arch remains controversial. This study aims to evaluate the long-term outcomes of acute type A aortic dissection treated with total arch replacement combined with frozen elephant trunk implantation in a large single-center cohort.
METHODS: From 2010 to 2022, patients with acute type A aortic dissection who received total arch replacement with frozen elephant trunk implantation at Fuwai Hospital were selected for clinical data collection and long-term follow-up. Logistic regression and Cox regression analyses were performed to identify risk factors for operative mortality, long-term mortality, and reoperation.
RESULTS: A total of 1672 patients underwent total arch replacement with frozen elephant trunk implantation, of whom 79.9% (1336/1672) were male with a median age of 48 years. The operative mortality rate was 6.3% (105/1672). The 10-year survival was 81.4%, and the most extended follow-up was over 13 years. Among the survivors, 89.7% (1303/1453) had complete self-care ability and were able to engage in general physical work. The 10-year cumulative incidence of reoperation was 13.3%. Multivariable logistic regression analysis revealed that male gender was associated with a reduced risk of operative death (odds ratio, 0.95, 95% CI, 0.92-0.98) and long-term death (hazard ratio, 0.68, 95% CI, 0.48-0.96).
CONCLUSIONS: Total arch replacement with frozen elephant trunk implantation demonstrates acceptable operative mortality and promising long-term outcomes for acute type A aortic dissection. Female patients face higher risks of operative and long-term mortality compared with male patients. Total arch replacement with frozen elephant trunk implantation provides patients with encouraging long-term quality of life and is advisable for acute type A aortic dissection in experienced centers.
METHODS: From 2010 to 2022, patients with acute type A aortic dissection who received total arch replacement with frozen elephant trunk implantation at Fuwai Hospital were selected for clinical data collection and long-term follow-up. Logistic regression and Cox regression analyses were performed to identify risk factors for operative mortality, long-term mortality, and reoperation.
RESULTS: A total of 1672 patients underwent total arch replacement with frozen elephant trunk implantation, of whom 79.9% (1336/1672) were male with a median age of 48 years. The operative mortality rate was 6.3% (105/1672). The 10-year survival was 81.4%, and the most extended follow-up was over 13 years. Among the survivors, 89.7% (1303/1453) had complete self-care ability and were able to engage in general physical work. The 10-year cumulative incidence of reoperation was 13.3%. Multivariable logistic regression analysis revealed that male gender was associated with a reduced risk of operative death (odds ratio, 0.95, 95% CI, 0.92-0.98) and long-term death (hazard ratio, 0.68, 95% CI, 0.48-0.96).
CONCLUSIONS: Total arch replacement with frozen elephant trunk implantation demonstrates acceptable operative mortality and promising long-term outcomes for acute type A aortic dissection. Female patients face higher risks of operative and long-term mortality compared with male patients. Total arch replacement with frozen elephant trunk implantation provides patients with encouraging long-term quality of life and is advisable for acute type A aortic dissection in experienced centers.