Current Outcome after Surgery for Type A Aortic Dissection.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Biancari Fausto, Juvonen Tatu, Fiore Antonio, Perrotti Andrea, Hervé Amélie, Touma Joseph, Pettinari Matteo, Peterss Sven, Buech Joscha, Dell'Aquila Angelo M, Wisniewski Konrad, Rukosujew Andreas, Demal Till, Conradi Lenard, Pol Marek, Kacer Petr, Onorati Francesco, Rossetti Cecilia, Vendramin Igor, Piani Daniela, Rinaldi Mauro, Ferrante Luisa, Quintana Eduard, Pruna-Guillen Robert, Rodriguez Lega Javier, Pinto Angel G, Acharya Metesh, El-Dean Zein, Field Mark, Harky Amer, Nappi Francesco, Gerelli Sebastien, Di Perna Dario, Gatti Giuseppe, Mazzaro Enzo, Rosato Stefano, Raivio Peter, Jormalainen Mikko, Mariscalco Giovanni
Аннотация
SUMMARY BACKGROUND DATA: The optimal extent of aortic resection during surgery for acute TAAD is controversial.
METHODS: This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals.
RESULTS: Out of 3902 consecutive patients, 689 (17.7%) died during the index hospitalization. Among 2855 patients who survived 3 months after surgery, 10-year observed survival was 65.3%, while country-adjusted, age-adjusted, and sex-adjusted expected survival was 81.3%, yielding a relative survival of 80.4%. Among 558 propensity score-matched pairs, total aortic arch replacement increased the risk of in-hospital (21.0% vs. 14.9%, P =0.008) and 10-year mortality (47.1% vs. 40.1%, P =0.001), without decreasing the incidence of distal aortic reoperation (10-year: 8.9% vs. 7.4%, P =0.690) compared with ascending aortic replacement. Among 933 propensity score-matched pairs, in-hospital mortality (18.5% vs. 18.0%, P =0.765), late mortality (at 10-year: 44.6% vs. 41.9%, P =0.824), and cumulative incidence of proximal aortic reoperation (at 10-year: 4.4% vs. 5.9%, P =0.190) after aortic root replacement was comparable to supracoronary aortic replacement.
CONCLUSIONS: Replacement of the aortic root and aortic arch did not decrease the risk of aortic reoperation in patients with TAAD and should be performed only in the presence of local aortic injury or aneurysm. The relative survival of TAAD patients is poor and suggests that the causes underlying aortic dissection may also impact late mortality despite surgical repair of the dissected aorta.