■研究在心脏外科手术过程中发生的医源性急性A型主动脉夹层(ATAD)的即时(表上)识别和手术治疗的短期和中期结果。
■从2016年1月至2020年12月在我们机构接受心脏外科手术的23,143名成年患者中,21名(0.09%)患有术中医源性ATAD并立即接受了主动脉修复。他们的临床特征,分析院内结局和随访结果.
■在21名患者中,13人(61.9%)患有高血压,14例(66.7%)升主动脉扩张。住院死亡率为9.5%,并记录了1例患者的永久性神经功能缺损新发.在36.0个月的中位随访中,所有18例随访患者均存活,没有重复手术.随访计算机断层扫描(CT)检查显示,3例患者的主动脉弓和8例的降主动脉中存在残留的假腔,其中1例存在残留的假腔灌注。
■在心脏外科手术中作为并发症发展的ATAD的立即识别和手术修复与低死亡率和高中期生存率相关。
UNASSIGNED: To investigate short- and intermediate-term outcomes of immediate (on table) recognition and surgical treatment of
iatrogenic acute type A aortic dissection (ATAD) that occurred during the course of the cardiac surgical procedures.
UNASSIGNED: Of 23,143 adult patients undergoing cardiac surgical procedures at our institution from January 2016 to December 2020, 21 (0.09%) suffered from intraoperative
iatrogenic ATAD and underwent immediate aortic repair. Their clinical characteristics, in-hospital outcomes and follow-up results were analyzed.
UNASSIGNED: Among the 21 patients, 13 (61.9%) suffered from hypertension, and 14 (66.7%) had a dilated ascending aorta. In-hospital mortality was 9.5%, and new onset of permanent neurologic deficit was recorded in one patient. During a median follow-up of 36.0 months, all 18 follow-up patients survived without repeated surgeries. A follow-up computed tomography (CT) examination revealed a residual false lumen in the aortic arch in 3 patients and in the descending aorta in 8, with residual false lumen perfusion in one.
UNASSIGNED: Immediate recognition and surgical repair of ATAD that developed as a complication during cardiac surgical procedures are associated with low mortality and high intermediate-term survival.