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Abstract：
BACKGROUND: Thoracic aorta false aneurysms (TAFA) are unexplored complications after cardiac surgery associated with significant morbidity and mortality. Therefore, the purpose of this study was to examine the clinical profiles, surgical techniques, and operative outcomes, of patients treated for TAFA at a single institution.
METHODS: From 1996 to 2022, 112 patients were treated for aortic pseudoaneurysm (mean age 55 ± 14 years, 78 patients were male). In the majority of the patients (90%) TAFA developed after previous cardiovascular surgery, the most common diagnosis and surgical procedure preceding the TAFA development was an aortic dissection (52%) and Bentall procedure (47%). In the rest of the cohort, the leading cause was trauma.
RESULTS: Sixty-one percent of patients were indicated for reintervention (surgical reoperation, endoluminal graft implantation, septal occluder implantation, coil embolization, or a combination of procedures). Overall, 52 patients had undergone cardiac reoperation. TAFA was resected and the aorta was repaired in 55% or replaced in 45%. Operative mortality was 5.7%. In postoperative follow-up, a hypoechogenic lesion encircling aortic prosthesis was present in 94%, therefore it was determined as a negative prognostic factor. The mean follow-up was 13.2 ± 19.4 years.
CONCLUSIONS: Although there is no specific approach how to prevent TAFA development, maintaining normal blood pressure and regular follow-up should be applied. More frequent follow-ups should be performed in patients with a hypoechogenic lesion encircling and aortic prosthesis. Early detection during long-term postoperative follow-up, an individually tailored approach of a multidisciplinary team is necessary for favorable treatment outcomes.
METHODS: From 1996 to 2022, 112 patients were treated for aortic pseudoaneurysm (mean age 55 ± 14 years, 78 patients were male). In the majority of the patients (90%) TAFA developed after previous cardiovascular surgery, the most common diagnosis and surgical procedure preceding the TAFA development was an aortic dissection (52%) and Bentall procedure (47%). In the rest of the cohort, the leading cause was trauma.
RESULTS: Sixty-one percent of patients were indicated for reintervention (surgical reoperation, endoluminal graft implantation, septal occluder implantation, coil embolization, or a combination of procedures). Overall, 52 patients had undergone cardiac reoperation. TAFA was resected and the aorta was repaired in 55% or replaced in 45%. Operative mortality was 5.7%. In postoperative follow-up, a hypoechogenic lesion encircling aortic prosthesis was present in 94%, therefore it was determined as a negative prognostic factor. The mean follow-up was 13.2 ± 19.4 years.
CONCLUSIONS: Although there is no specific approach how to prevent TAFA development, maintaining normal blood pressure and regular follow-up should be applied. More frequent follow-ups should be performed in patients with a hypoechogenic lesion encircling and aortic prosthesis. Early detection during long-term postoperative follow-up, an individually tailored approach of a multidisciplinary team is necessary for favorable treatment outcomes.
摘要：
背景：胸主动脉假性动脉瘤（TAFA）是心脏手术后尚未发现的并发症，与显著的发病率和死亡率相关。因此,这项研究的目的是检查临床概况，外科技术,和手术结果，在单一机构接受TAFA治疗的患者。
方法：从1996年到2022年，112例患者接受了主动脉假性动脉瘤治疗（平均年龄55±14岁，78例患者为男性)。在大多数患者（90％）中，TAFA是在以前的心血管手术后发展的，TAFA发生前最常见的诊断和外科手术是主动脉夹层(52%)和Bentall手术(47%).在其他人中，主要原因是外伤.
结果：61％的患者接受了再干预（手术再手术，腔内移植物植入，间隔封堵器植入,线圈栓塞,或程序的组合)。总的来说,52例患者进行了心脏再手术。切除了TAFA，修复了55％的主动脉或替换了45％的主动脉。手术死亡率为5.7%。在术后随访中，围绕主动脉假体的低回声病变占94%，因此，它被确定为阴性预后因素。平均随访13.2±19.4年。
结论：虽然没有防止TAFA发展的具体方法，应保持正常血压和定期随访。对于低回声病变环绕和主动脉假体的患者，应进行更频繁的随访。术后长期随访早期发现，多学科团队个性化的方法对于良好的治疗结果是必要的.
方法：从1996年到2022年，112例患者接受了主动脉假性动脉瘤治疗（平均年龄55±14岁，78例患者为男性)。在大多数患者（90％）中，TAFA是在以前的心血管手术后发展的，TAFA发生前最常见的诊断和外科手术是主动脉夹层(52%)和Bentall手术(47%).在其他人中，主要原因是外伤.
结果：61％的患者接受了再干预（手术再手术，腔内移植物植入，间隔封堵器植入,线圈栓塞,或程序的组合)。总的来说,52例患者进行了心脏再手术。切除了TAFA，修复了55％的主动脉或替换了45％的主动脉。手术死亡率为5.7%。在术后随访中，围绕主动脉假体的低回声病变占94%，因此，它被确定为阴性预后因素。平均随访13.2±19.4年。
结论：虽然没有防止TAFA发展的具体方法，应保持正常血压和定期随访。对于低回声病变环绕和主动脉假体的患者，应进行更频繁的随访。术后长期随访早期发现，多学科团队个性化的方法对于良好的治疗结果是必要的.
