Nienaber C A, Akin I, Kische S, Ince H, Chatterjee T
Unversitäres Herzzentrum Rostock, Medizinische Klinik I, Universität Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.
Internist (Berl). 2013 May;54(5):561-71. doi: 10.1007/s00108-012-3219-y.
Considering the demographic changes in our society and the proliferation of imaging-based improved diagnostics, both acute and chronic aortic diseases attract increasing attention and require dedicated care. Cardiac as well as vascular surgery used to represent the gold standards for therapeutic management of pathologies of the ascending aorta and the arch; however, the technological evolution of endoluminal strategies has had a serious impact on the treatment of the descending aorta, the aortic arch in combination with vascular debranching or bypass, and in selected cases even on managing pathologies of the ascending aorta. Although several case series and meta-analyses of published observations hint towards superiority of endografting in comparison to open surgical repair, the affected usually multimorbid patients with highly complex aortic disease should be subjected to an individual evaluation by a team of cardiologists, cardiac and vascular surgeons as well as imaging specialists; a dedicated individualized treatment concept in highly experienced centers of excellence is likely to provide the best results for such challenging patients.
考虑到我们社会的人口结构变化以及基于影像的诊断技术的不断发展，急性和慢性主动脉疾病都受到越来越多的关注，需要专门的护理。心脏和血管外科手术曾经是升主动脉和主动脉弓病变治疗管理的金标准；然而，腔内治疗策略的技术发展对降主动脉、主动脉弓合并血管分支或旁路的治疗产生了重大影响，在某些情况下甚至对升主动脉病变的管理也产生了影响。尽管一些已发表观察结果的病例系列和荟萃分析表明，与开放手术修复相比，腔内修复具有优势，但通常患有多种疾病且主动脉疾病高度复杂的患者应由心脏病专家、心脏和血管外科医生以及影像专家团队进行个体评估；在经验丰富的卓越中心采用专门的个体化治疗方案可能会为这类具有挑战性的患者带来最佳治疗效果。
