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新冠阳性患者的 A 型主动脉综合征:来自英国多中心研究的病例系列。

Type A aortic syndromes in COVID-19 positive patients: Case series from a UK multicentre study.

机构信息

Departments of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK.

Departments of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.

出版信息

J Card Surg. 2021 Aug;36(8):2692-2696. doi: 10.1111/jocs.15625. Epub 2021 May 12.

Abstract

OBJECTIVE

The coronavirus disease (COVID-19) increases the respiratory complications and carries a higher mortality in the immediate postoperative period. The aim of this study was to analyze the outcomes of patients with type A acute aortic syndromes (AAS) diagnosed with COVID-19 in the perioperative period.

METHODS

Retrospective analysis of prospectively collected data between March and August 2020 from 20 participating cardiac surgery centers in the United Kingdom.

RESULTS

Among 122 patients who underwent emergency surgical repair for type A AAS at the participating centers, 3 patients (2.5%) tested positive for COVID-19 in the preoperative screeing, and 4 cases turned to be positive in the postoperative period having been operated on an unknown COVID-19 status. Another patient was diagnosed of COVID-19 disease based on radiological features. These eight patients had increased postoperative complications, including respiratory failure, longer ventilation times, and Intensive Therapy Unit (ITU) stay and increased mortality when compared with COVID-19 negative patients.

CONCLUSION

COVID-19 disease in the perioperative period of type A AAS poses a challenge. Despite the increasing morbidity and mortality associated with the virus, the prognosis of the aortic disease is poorer and emergency surgery should not be contraindicated based on the COVID-19 diagnosis alone.

摘要

目的

新冠病毒疾病(COVID-19)会增加呼吸系统并发症,并使患者在术后立即出现更高的死亡率。本研究旨在分析围手术期确诊 COVID-19 的急性主动脉综合征(AAS)A型患者的预后。

方法

对 2020 年 3 月至 8 月期间英国 20 家参与心脏外科中心前瞻性收集的数据进行回顾性分析。

结果

在参与中心接受紧急外科修复的 122 例 AAS 型患者中,术前筛查中发现 3 例(2.5%)COVID-19 检测呈阳性,4 例术后检测呈阳性,其 COVID-19 状态未知。另一名患者根据影像学特征诊断为 COVID-19 疾病。与 COVID-19 阴性患者相比,这 8 例患者术后并发症增加,包括呼吸衰竭、通气时间延长、重症监护病房(ITU)入住时间延长和死亡率增加。

结论

A型 AAS 围手术期的 COVID-19 疾病带来了挑战。尽管与该病毒相关的发病率和死亡率增加,但主动脉疾病的预后更差,不应仅根据 COVID-19 诊断来禁止急诊手术。

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