Budillon A M, Nicolini F, Beghi C, Saccani S, De Cicco G, Albertini D, Agostinelli A, Ballore L, Gherli T
Cattedra e Divisione di Cardiochirurgia, Università degli Studi di Parma.
Acta Biomed Ateneo Parmense. 2001;72(1-2):33-43.
Between January 1990 and February 2001 a total of 323 patients underwent following operations at our Institution: respectively 256 on the ascending aorta, 13 on the transverse arch and 54 on thoracic descending aorta. Sixteen patients with thoracic aortic aneurysms underwent endovascular stent graft implantation. The overall in-hospital mortality was respectively: 7% for ascending aortic aneurysms, 7.7% in the aortic arch aneurysms group and 5.5% for descending aortic aneurysms. The mortality was greater in case of emergency surgery and in the subgroup of patients with acute type A dissection. Stroke with permanent dysfunction occurred in 1.5% of ascending aneurysms, 7.7% of arch aneurysms and in 3.7% of thoracic descending aneurysms. In the latter group, all the major neurological events were related to conventional surgical procedures only: really no mortality or neurological morbidity occurred with endovascular stent graft implantation. Even if modern physiologic monitoring devices and new surgical techniques have been developed in the last years, the treatment of thoracic aortic aneurysms remains challenging. Endoluminal placement of stent grafts has developed as an alternative procedure for the treatment of thoracic aortic aneurysms, even if longer term follow-up is still necessary to fully define the efficacy of this approach.
1990年1月至2001年2月期间，共有323例患者在我院接受了以下手术：升主动脉手术256例，主动脉弓手术13例，胸降主动脉手术54例。16例胸主动脉瘤患者接受了血管内支架植入术。总体住院死亡率分别为：升主动脉瘤患者7%，主动脉弓瘤患者7.7%，降主动脉瘤患者5.5%。急诊手术患者和急性A型夹层患者亚组的死亡率更高。永久性功能障碍性卒中在升主动脉瘤患者中发生率为1.5%，在主动脉弓瘤患者中为7.7%，在胸降主动脉瘤患者中为3.7%。在后者组中，所有主要神经事件仅与传统手术操作有关：血管内支架植入术确实未发生死亡或神经并发症。尽管近年来已开发出现代生理监测设备和新的手术技术，但胸主动脉瘤的治疗仍然具有挑战性。血管内支架植入术已发展成为治疗胸主动脉瘤的替代手术，尽管仍需要更长时间的随访来充分确定这种方法的疗效。
