Long-term outcome and prognostic predictors of medically treated acute type B aortic dissections
Long-term outcome and prognostic predictors of medically treated acute type B aortic dissections
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DOI：
10.1016/j.athoracsur.2004.02.031
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发表时间：
2004-10-01
影响因子：
4.6
通讯作者：
Aoyagi, S
中科院分区：
文献类型：
--
作者：
Onitsuka, S;Akashi, H;Aoyagi, S
背景。本研究的目的是检查与急性 B 型主动脉夹层相关并发症的发生相关的长期结果和预后预测因素。方法。 1990 年至 2001 年间，对 76 名接受治疗的急性 B 型主动脉夹层患者进行了检查。与主动脉夹层相关的事件包括夹层相关死亡、破裂、内脏缺血、下肢缺血、主动脉最大直径增加超过 50 毫米以及每年平均扩大率超过 5 毫米。 结果。在 76 名患者中，10 名 (13%) 接受了慢性期手术，25 名 (33%) 出现事件。在动脉粥样硬化因素、假腔血流状态、入院时最大主动脉直径、平均主动脉扩张率和随访期间血压控制方面，发生和未发生事件的患者之间观察到统计学显着差异。在这些因素中，假腔开放和入院时最大主动脉直径大于 40 毫米是与事件发展最密切相关的因素。入院时假腔未闭且最大主动脉直径大于 40 毫米的患者的事件发生率明显高于其他患者。结论。在确定急性 B 型主动脉夹层的适当治疗方法时，重要的是要仔细注意假腔未闭和发病时最大主动脉直径大于 40 毫米的预测因素，以改善长期结果。 (C) 2004 年，胸外科医师协会。
Background. The purpose of this study was to examine the long-term outcome and the prognostic predictors related to the development of complications associated with acute type B aortic dissection.Methods. Seventy-six medically treated patients with acute type B aortic dissection were examined between 1990 and 2001. The events associated with aortic dissection included dissection-related death, rupture, visceral ischemia, lower limb ischemia, an increase in the maximum aortic diameter greater than 50 mm, and a mean enlargement rate of greater than 5 mm per year.Results. Among the 76 patients 10 (13%) underwent chronic phase surgery and 25 (33%) presented with an event. A statistically significant difference was observed between patients with and without events with regard to atherosclerotic factors, blood flow status in the false lumen, maximum aortic diameter upon admission, mean aortic enlargement rate, and blood pressure control during follow-up. Of these factors a patent false-lumen and a maximum aortic diameter greater than 40 mm upon admission were the most strongly associated factors with regard to the development of events. Patients with a patent false-lumen and a maximum aortic diameter greater than 40 mm upon admission were determined to exhibit significantly higher event rates than other patients.Conclusions. In determining the appropriate therapeutic approach for acute type B aortic dissection, it is important to pay careful attention to the predictors of a patent false-lumen and a maximum aortic diameter greater than 40 mm at onset to improve the long-term outcome. (C) 2004 by The Society of Thoracic Surgeons.