Karimi Ashkan, McCord Matthew R, Beaver Thomas M, Martin Tomas D, Hess Philip J, Beck Adam W, Feezor Robert J, Klodell Charles T
Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida.
Department of Surgery, University of Florida, Gainesville, Florida.
J Card Surg. 2016 May;31(5):334-40. doi: 10.1111/jocs.12722. Epub 2016 Mar 27.
To study the short and mid-term outcomes of thoracic aortic operations in patients ≥80 years old.
This is a retrospective chart review of patients ≥80 years old who underwent thoracic aortic operation in our institution between 2006 and 2013.
Ninety-eight patients were studied. Fifty-four patients underwent open repair; 41 underwent endovascular repair; and three underwent hybrid repair with aortic arch debranching and subsequent endovascular stent graft. Hospital mortality rate among the entire cohort was 11/98 (11%): 7/54 (13%) for open repair; 2/41 (5%) for endovascular repair; and 2/3 (66%) for hybrid repair. Major adverse events occurred in 23/98 (23%) in the entire cohort: 15/54 (28%) in open repair; 5/41 (12%) in endovascular repair; and 3/3 (100%) in hybrid repair. Mean follow-up was 31 ± 28 months (median 26 months). Two- and five-year survival rates were 57%, and 34% for the open approach and 71%, and 43% for the endovascular approach respectively.
Both open and endovascular thoracic aortic repairs can be performed with favorable mortality and perioperative morbidity in appropriately selected octogenarian patients. doi: 10.1111/jocs.12722 (J Card Surg 2016;31:334-340).
研究80岁及以上患者胸主动脉手术的短期和中期结果。
这是一项对2006年至2013年间在本机构接受胸主动脉手术的80岁及以上患者进行的回顾性图表审查。
共研究了98例患者。54例接受开放修复；41例接受血管腔内修复；3例接受主动脉弓去分支并随后进行血管腔内支架植入的杂交修复。整个队列的医院死亡率为11/98（11%）：开放修复为7/54（13%）；血管腔内修复为2/41（5%）；杂交修复为2/3（66%）。整个队列中23/98（23%）发生了主要不良事件：开放修复为15/54（28%）；血管腔内修复为5/41（12%）；杂交修复为3/3（100%）。平均随访时间为31±28个月（中位数26个月）。开放手术的两年和五年生存率分别为57%和34%，血管腔内手术分别为71%和43%。
对于经过适当选择的八旬患者，开放和血管腔内胸主动脉修复均可取得良好的死亡率和围手术期发病率。doi: 10.1111/jocs.12722（《心血管外科杂志》2016年；31:334 - 340）
