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.
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.