Chapman J E, Rubin J W, Ellison R G, Moore H V, Kamath M V, Pai G P, Sussman A M, Fuhrman G M
Section of Thoracic and Cardiac Surgery, Medical College of Georgia, Augusta 30912-2423.
South Med J. 1988 Jan;81(1):32-6. doi: 10.1097/00007611-198801000-00007.
We present our 12-year experience with surgical treatment of aneurysms of the thoracic aorta in a high-risk patient population. Of 52 patients with aneurysms, 36 patients, aged 19 to 80 years, had operation. In 24 of the 36, there were three or more associated major disease processes, such as chronic bronchitis, hypertensive cardiovascular disease, aortic valve disease, cerebrovascular disease, abdominal aortic aneurysm, and coronary artery disease. Eight patients with acute type A (ascending aorta) and seven with acute type B (descending aorta) aneurysms had emergency repair, with survival in four and seven, respectively. All patients with chronic type A or B aneurysms had elective repair, and all patients with acute or chronic type A aneurysms had surgical treatment. Four patients with acute type A and two with acute type B aneurysms had elective operation, with survival in three and one, respectively. Nine patients with chronic type A and six with chronic type B aneurysms had elective operation, and all survived. Twelve patients with chronic type B aneurysms did not have operation, and all were alive at early follow-up. Mortality for patients having acute type A aneurysms requiring emergency operation was greater than that after elective repair of acute or chronic type A aneurysms. Short-term survival for chronic type B aneurysms was similar whether the patient was treated medically or surgically.
我们介绍了在高危患者群体中进行胸主动脉瘤手术治疗的12年经验。在52例动脉瘤患者中，36例年龄在19至80岁之间的患者接受了手术。在这36例患者中，有24例存在三种或更多相关的主要疾病进程，如慢性支气管炎、高血压性心血管疾病、主动脉瓣疾病、脑血管疾病、腹主动脉瘤和冠状动脉疾病。8例急性A型（升主动脉）和7例急性B型（降主动脉）动脉瘤患者接受了急诊修复，分别有4例和7例存活。所有慢性A型或B型动脉瘤患者均接受了择期修复，所有急性或慢性A型动脉瘤患者均接受了手术治疗。4例急性A型和2例急性B型动脉瘤患者接受了择期手术，分别有3例和1例存活。9例慢性A型和6例慢性B型动脉瘤患者接受了择期手术，且全部存活。12例慢性B型动脉瘤患者未接受手术，在早期随访时均存活。需要急诊手术的急性A型动脉瘤患者的死亡率高于急性或慢性A型动脉瘤择期修复后的死亡率。慢性B型动脉瘤患者无论接受药物治疗还是手术治疗，短期生存率相似。
