Long-term survival of patients with treated aortic dissection.
Long-term survival of patients with treated aortic dissection.
复制标题
接受治疗的主动脉夹层患者的长期生存。
DOI：
10.1016/s0735-1097(84)80363-0
复制
发表时间：
1984
影响因子：
24
通讯作者：
S. Rosenthal
中科院分区：
文献类型：
--
作者：
Robert M. Doroghazi;Eve E. Slater;R. Desanctis;M. Buckley;W. Austen;S. Rosenthal
本文报告了1963年至1978年在马萨诸塞州总医院治疗主动脉夹层的回顾性资料。在此期间，160例自发性主动脉夹层患者接受了明确的药物或明确的手术治疗。根据夹层类型（近端与远端）和持续时间（急性与慢性）对患者进行分类。156例病例获得长期随访（平均48个月，范围1至147个月）。根据夹层本身的特征和与最终生存率相关的后续治疗，对每种夹层的住院和晚期生存率进行了评估，结果表明：1）慢性表现是住院和晚期生存率的最重要决定因素; 2）急性夹层的预后主要取决于是否有严重并发症，而与最终治疗无关;对生存率没有不利影响的唯一并发症是主动脉瓣关闭不全; 3）对于所有类型的夹层和治疗模式的患者，出院后的晚期生存率相似; 4）主动脉夹层的晚期并发症的发生率低于先前报道的。因此，早期明确的药物和手术治疗的成功在长期随访中得以维持。
Retrospective data on the treatment of aortic dissection at the Massachusetts General Hospital from 1963 to 1978 are reported. During this period, 160 patients with spontaneous aortic dissection were treated by definitive medical or definitive surgical therapy. Patients were classified according to type (proximal versus distal) and duration (acute versus chronic) of dissection. Long-term followup (mean 48 months, range 1 to 147) was available in 156 cases. Hospital and late survival in each of the categories of dissection were evaluated in relation to those features of the dissection itself and of the subsequent therapy that correlated with ultimate survival.Results show that: 1) chronic presentation was the most significant determinant of both hospital and late survival; 2) in acute dissection, prognosis was determined largely by the presence or absence of major complications, regardless of ultimate therapy; the only complication without adverse effect on survival was aortic insufficiency; 3) late survival after discharge from the hospital was similar for patients with all types of dissection and modes of therapy; and 4) the incidence of late complications from aortic dissection was lower than previously reported. Thus, the success of early definitive medical and surgical treatment was sustained on longterm follow-up.