Service de chirurgie vasculaire et cardiothoracique, hôpital Henri-Mondor, 51, avenue du Maréchal-de Lattre-de-Tassigny, 94000 Créteil, France.
Arch Cardiovasc Dis. 2011 Feb;104(2):125-30. doi: 10.1016/j.acvd.2010.11.009. Epub 2011 Feb 17.
Operated acute DeBakey type I aortic dissection has to be considered as a chronic aortic disease with the potential of late distal dilatation with aneurysm formation and need for reoperation. Several intraoperative strategies have been devised to prevent late complications. However, the increased operative risk associated with a more aggressive initial approach in an emergent setting has to be balanced against the relatively low incidence of late reoperations. Further studies will have to identify preoperative risk factors for late distal aortic complications more precisely in order to select patients who might benefit the most from these newer surgical strategies.
手术治疗的急性 DeBakey Ⅰ型主动脉夹层应被视为一种慢性主动脉疾病，可能会出现晚期远端扩张、形成动脉瘤，并需要再次手术。已经设计了几种术中策略来预防晚期并发症。然而，在紧急情况下采用更积极的初始方法会增加手术风险，因此必须权衡与晚期再次手术相关的相对较低的发生率。进一步的研究必须更精确地确定晚期远端主动脉并发症的术前危险因素，以便选择最能从这些新的手术策略中获益的患者。
