Thoracoabdominal aortic aneurysm repair: Review and update of current strategies
Thoracoabdominal aortic aneurysm repair: Review and update of current strategies
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DOI：
10.1016/s0003-4975(02)04139-5
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发表时间：
2002-11-01
影响因子：
4.6
通讯作者：
LeMaire, SA
中科院分区：
文献类型：
--
作者：
Coselli, JS;Conklin, LD;LeMaire, SA
背景胸腹主动脉瘤的外科修复术仍然是一项技术上具有挑战性的手术，需要采用多种方法来预防缺血性并发症。本报告的目的是更新我们的经验，并强调我们目前的临床策略。1986年1月1日至2001年12月31日，1,773例患者接受了胸腹主动脉瘤修复术。这些患者中的大多数（1，153，65%）需要Crawford I级或II级修复。1,082例（61%）患者行节段性肋间动脉或腰动脉再接术，686例（38.7%）患者行左心转流术，173例（9.8%）患者行脑脊液引流术。30天生存率为94.3%（1，672例患者）。术后并发症包括105例（5.9%）需要血液透析的肾衰竭和79例（4.5%）截瘫或轻瘫。5年生存率为73.5% ± 1.6%。该临床经验表明，目前的技术策略使患者能够接受胸腹主动脉瘤修复术，具有良好的早期生存率和可接受的发病率。(C)2002年由胸外科医师协会出版。
Background. Surgical repair of thoracoabdominal aortic aneurysms remains a technically challenging operation that requires a multimodality approach to preventing ischemic complications. The purpose of this report is to update our experience and highlight our current clinical strategies.Methods. Between January 1, 1986 and December 31, 2001, 1,773 patients underwent thoracoabdominal aortic aneurysm repair. The majority of these patients (1,153,65%) required Crawford extent I or II repairs. Segmental intercostal or lumbar arteries were reattached in 1,082 patients (61%); left heart bypass was used in 686 patients (38.7%), and 173 patients (9.8%) had cerebrospinal fluid drainage.Results. The 30-day survival rate was 94.3% (1,672 patients). Postoperative complications included renal failure requiring hemodialysis in 105 patients (5.9%) and paraplegia or paraparesis in 79 patients (4.5%). Actuarial 5-year survival was 73.5% +/- 1.6%.Conclusions. This clinical experience demonstrates that current technical strategies enable patients to undergo thoracoabdominal aortic aneurysm repair with excellent early survival and acceptable morbidity. (C) 2002 by The Society of Thoracic Surgeons.