Department of Surgery and Radiology, Section of Vascular Surgery, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
Ann Thorac Surg. 2010 Jun;89(6):2061-6. doi: 10.1016/j.athoracsur.2009.11.020.
The authors reviewed all published series of type A iatrogenic aortic dissections and performed meta-analyses to investigate the management and outcomes of this complication. The majority of type A iatrogenic aortic dissections occurred during cardiac surgery, but the incidence of iatrogenic aortic dissection was considerably higher during thoracic endovascular aortic repair. Intraoperative diagnosis of iatrogenic aortic dissection was made in 69% of patients, and surgical repair of the dissection was performed in 88%. The overall in-hospital mortality was 38%, and the intraoperative diagnoses (odds ratio 0.35; p = 0.01) and surgical repairs (odds ratio 0.09; p = 0.001) were associated with reduced in-hospital mortality in univariate regression analysis.
作者回顾了所有已发表的 A 型医源性主动脉夹层病例系列，并进行了荟萃分析，以研究这种并发症的治疗和结果。大多数 A 型医源性主动脉夹层发生在心脏手术期间，但在胸主动脉腔内修复术中，医源性主动脉夹层的发生率明显更高。术中诊断医源性主动脉夹层的患者占 69%，对夹层进行手术修复的患者占 88%。总的院内死亡率为 38%，术中诊断（比值比 0.35；p = 0.01）和手术修复（比值比 0.09；p = 0.001）与单因素回归分析中的院内死亡率降低相关。
