背景:我们介绍了主动脉弓疾病I型和II型混合手术的单机构结果,以及30天和长期结果,并回顾了文献。
方法:这是一项回顾性研究,对2013年1月至2020年期间在我们机构接受了0区内移植和从升主动脉到拱形血管的开放旁路术的所有患者进行研究。系统评价的以下数据来自符合条件的研究:30天/住院死亡率,中风率,脊髓缺血(SCI)率,肾衰竭需要透析,逆行解剖的发展,早期(<30天)I型和III型内漏,随访长度,晚期(>30天)内漏,和晚期(>30天)死亡率。
结果:12例患者在我们机构接受了混合主动脉弓治疗。最常见的主动脉弓病理是退行性主动脉瘤。逆行夹层和SCI的发生率为8.33%。关于文献数据,共有768例接受I型和II型混合主动脉弓脱支手术的患者.30天/住院死亡率的汇总率为10.96%(95%置信区间[CI],8.21-14.06),SCI合并率为2.91%(95%CI,1.76%-4.33%),逆行夹层合并率为3.22%(95%CI,1.99-4.72)。
结论:混合足弓技术为开放修复提供了安全的替代方案,短期和中期效果可接受。
BACKGROUND: We present single-institution results of types I and II hybrid procedures for aortic arch disease with 30-day and long-term results and review of the literature.
METHODS: This is a retrospective study of all patients that underwent zone 0 endografting and open bypass from ascending aorta to the arch vessels at our institution between January 2013 and 2020. The following data for the systematic review were extracted from eligible studies: 30-day/in-hospital mortality, stroke rate, spinal cord ischemia (SCI) rate, renal failure requiring dialysis, development of retrograde dissection, early (<30 days) types I and III endoleak, follow-up length, late (>30 days) endoleak, and late (>30 days) mortality.
RESULTS: Twelve patients underwent hybrid aortic arch treatment in our institution. The most common aortic arch pathology was degenerative aortic aneurysm. The rate of retrograde dissection and SCI was 8.33%. Regarding the literature data, a total of 768 patients undergoing types I and II hybrid aortic arch debranching procedure. The pooled rate of 30-day/in-hospital mortality was 10.96% (95% confidence interval [CI], 8.21-14.06), SCI pooled rate was 2.91% (95% CI, 1.76%-4.33%), and retrograde dissection pooled rate was 3.22% (95% CI, 1.99-4.72).
CONCLUSIONS: Hybrid arch techniques provide safe alternative to open repair with acceptable short- and midterm results.