Harky Amer, Hussain Syed Mohammad Asim, MacCarthy-Ofosu Beverly, Ahmad Mohammad Usman
Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, UK.
School of Medicine, University of Liverpool, Liverpool, UK.
Braz J Cardiovasc Surg. 2020 Dec 1;35(6):977-985. doi: 10.21470/1678-9741-2019-0367.
To review the currently available literature to define the role of thoracic endovascular aortic repair (TEVAR) in patients with connective tissue disorders (CTD).
A comprehensive electronic database search was performed in PubMed, SCOPUS, Embase, Google scholar, and OVID to identify all the articles that reported on outcomes of utilizing TEVAR in patients with CTD during elective and emergency settings. The search was not limited to time or language of the published study.
All the relevant studies have been summarized in its correspondence section. The outcomes were analyzed in narrative format. The role of TEVAR has been elaborated as per each study. Currently, there is limited large cohort size studies outlining the use of TEVAR in patients with CTD. The use of endovascular repair in patients with CTD is limited due to progressive aortic dilatations and high possibility of further reinterventions at later stage of life.
Open repair remains the gold standard method of intervention in young patients with progressive CTD, especially in the setting of acute type A aortic dissection. However, TEVAR can be sought as a reliable alternative in emergency setting of diseases involving the descending thoracic aorta; yet the long-term data needs to be published to support such practice.
回顾现有文献,以明确胸主动脉腔内修复术(TEVAR)在结缔组织病(CTD)患者中的作用。
在PubMed、SCOPUS、Embase、谷歌学术和OVID中进行全面的电子数据库检索,以识别所有报道在择期和急诊情况下对CTD患者使用TEVAR的结果的文章。检索不限于已发表研究的时间或语言。
所有相关研究已在其对应部分进行了总结。结果以叙述形式进行了分析。根据每项研究阐述了TEVAR的作用。目前,仅有有限的大型队列研究概述了TEVAR在CTD患者中的应用。由于主动脉进行性扩张以及在生命后期进一步再次干预的可能性较高,CTD患者中血管内修复的应用受到限制。
对于患有进行性CTD的年轻患者,尤其是在急性A型主动脉夹层的情况下,开放修复仍然是干预的金标准方法。然而,在涉及降主动脉的疾病的急诊情况下,TEVAR可被视为一种可靠的替代方法;但仍需要发表长期数据来支持这种做法。