PDF(Pubmed)
Abstract：
BACKGROUND: During the coronavirus disease (COVID-19) pandemic, medical resources have often been limited to emergency surgeries. This study aimed to evaluate our experience with delayed surgery for acute type A aortic dissections (ATAADs).
METHODS: A retrospective study was conducted on 33 patients who underwent surgery for ATAADs between January 2020 and December 2021. The patients were divided into two groups: patients treated within 12 h of arrival (E group; N = 21) and those treated > 12 h after arrival (D group; N = 12) with strict antihypertensive therapy until surgery.
RESULTS: The plasma fibrinogen levels on arrival were lower in the D group than in the E group (174.3 ± 109.1 vs 293.4 ± 165.4, p = 0.038). The time to surgery from symptom onset was longer in the D group than in the E group (4 ± 1 h vs. 86 ± 108 h, p < 0.001). There was one case (3%) of mortality and seven cases (21%) of cerebral infarctions in the E group. There was no significant difference in the intraoperative data and quantity of blood transfused between the two groups.
CONCLUSIONS: Thus, delayed surgery for ATAAD with appropriate preoperative management may be an alternative surgical strategy in the COVID-19 era.
METHODS: A retrospective study was conducted on 33 patients who underwent surgery for ATAADs between January 2020 and December 2021. The patients were divided into two groups: patients treated within 12 h of arrival (E group; N = 21) and those treated > 12 h after arrival (D group; N = 12) with strict antihypertensive therapy until surgery.
RESULTS: The plasma fibrinogen levels on arrival were lower in the D group than in the E group (174.3 ± 109.1 vs 293.4 ± 165.4, p = 0.038). The time to surgery from symptom onset was longer in the D group than in the E group (4 ± 1 h vs. 86 ± 108 h, p < 0.001). There was one case (3%) of mortality and seven cases (21%) of cerebral infarctions in the E group. There was no significant difference in the intraoperative data and quantity of blood transfused between the two groups.
CONCLUSIONS: Thus, delayed surgery for ATAAD with appropriate preoperative management may be an alternative surgical strategy in the COVID-19 era.
摘要：
背景：在冠状病毒病（COVID-19）大流行期间，医疗资源往往仅限于紧急手术。这项研究旨在评估我们对急性A型主动脉夹层（ATAADs）延迟手术的经验。
方法：对2020年1月至2021年12月接受ATAAD手术的33例患者进行了回顾性研究。将患者分为两组：到达后12小时内接受治疗的患者（E组；N=21）和到达后12小时内接受严格降压治疗的患者（D组；N=12）。
结果：D组血浆纤维蛋白原水平低于E组（174.3±109.1vs293.4±165.4，p=0.038）。D组从症状发作到手术的时间长于E组（4±1hvs.86±108小时,p<0.001)。E组死亡1例（3％），脑梗死7例（21％）。两组术中资料和输血量无明显差异。
结论：因此，在COVID-19时代,ATAAD的延迟手术和适当的术前管理可能是一种替代手术策略.
方法：对2020年1月至2021年12月接受ATAAD手术的33例患者进行了回顾性研究。将患者分为两组：到达后12小时内接受治疗的患者（E组；N=21）和到达后12小时内接受严格降压治疗的患者（D组；N=12）。
结果：D组血浆纤维蛋白原水平低于E组（174.3±109.1vs293.4±165.4，p=0.038）。D组从症状发作到手术的时间长于E组（4±1hvs.86±108小时,p<0.001)。E组死亡1例（3％），脑梗死7例（21％）。两组术中资料和输血量无明显差异。
结论：因此，在COVID-19时代,ATAAD的延迟手术和适当的术前管理可能是一种替代手术策略.
