AORTIC DISSECTION AND DISSECTING AORTIC-ANEURYSMS
AORTIC DISSECTION AND DISSECTING AORTIC-ANEURYSMS
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DOI：
10.1097/00000658-198809000-00002
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发表时间：
1988-09-01
影响因子：
9
通讯作者：
HESS, KR
中科院分区：
文献类型：
--
作者：
CRAWFORD, ES;SVENSSON, LG;HESS, KR
1956 ~ 1988年32年间，手术治疗主动脉夹层并发症546例。目前的概念和操作技术在此期间演变。幸运的是，随着现代治疗的标准化，大约一半的患者在后4年接受了治疗。所有患者的累积生存率为86%，近年来接受治疗的患者为94%。通过对174例曾行198次手术的患者进行治疗，使患者的病理过程和手术要求更加清晰。需要再次手术的并发症的操作现在被认为是过时的，心脏手术的患者升主动脉扩张，进行性扩张的残余段的主动脉。随访546例患者，最终共进行了838例手术，其中18例患者行全主动脉置换，41例患者行近全置换，22例患者行全胸主动脉置换，33例患者行近全胸主动脉置换，148例患者行全胸腹主动脉置换。最终手术后439例患者的5年和10年长期生存率分别为66%和44%，尽管首次入院时的中位年龄为59岁。手术治疗似乎是这种疾病的公认治疗方法。图像
Operation was employed in the treatment of 546 patients for complications of aortic dissection during the 32-year period of 1956-1988. Current concepts and operative techniques evolved during this period. Fortunately, about half the patients were treated during the latter 4 years, as modern therapy became standardized. The cumulative survival rate was 86% for all patients and 94% for those treated during recent years. Pathologic processes and requirements of operation became clearer by treating 174 patients who had had 198 previous operations by the time of referral. Reoperation was required for complications of operations now considered outdated, heart operations in patients with ascending aortic dilatation, and progressive dilatation of residual segments of the aorta. The 546 patients were followed, and a total of 838 operations were finally employed, resulting in total aortic replacement in 18, near total replacement in 41, entire thoracic aorta in 22, near total thoracic aorta in 33, and the entire thoracoabdominal aorta in 148 patients. Long-term survival in 439 patients after final operation was 66% and 44% at 5 and 10 years, respectively, despite the fact that the median age at first admission was 59. Operative treatment appears to be well-established for this disease. Images