Department of Cardiovascular Surgery, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
Heart Vessels. 2023 Jun;38(6):849-856. doi: 10.1007/s00380-023-02234-z. Epub 2023 Jan 31.
We investigated whether distal anastomosis to the true lumen in open surgical repair of descending aorta for chronic type B aortic dissection improved the long-term outcomes with aortic remodeling. We retrospectively reviewed 71 patients with chronic type B aortic dissection, excluding those with connective tissue disorder, from October 2001 to June 2021. The patients who underwent distal true lumen anastomosis (group T, n = 36) were compared to those with both lumens' anastomosis (group B, n = 35), regarding survival, overall and distal aortic events. The growth rates of the distal aorta (maximum diameter in descending thoracic, suprarenal and infrarenal abdominal aorta) were also investigated. Median age was significantly higher in group T (T; 66 vs B; 60, P = .001). Group T had significantly higher rates of complete and partial thrombosis formation in the false lumen than group B postoperatively (26.9 vs 0%, P = .01 for complete, 65.4 vs 3.9%, P < .0001 for partial, respectively). At median follow-up for 6.8 years of 63 patients (88.7%), survival, overall and distal aortic event-free rates, and the growth rates of the distal aorta were not significantly different between the groups. Distal anastomosis to the true lumen did not improve mid-term survival, aortic event-free rates and the growth rates of the distal aorta compared with that of both lumens for chronic type B aortic dissection.
我们研究了在慢性 B 型主动脉夹层的开放式外科修复中，远端吻合真腔是否能改善主动脉重塑的长期结果。我们回顾性分析了 2001 年 10 月至 2021 年 6 月期间 71 例慢性 B 型主动脉夹层患者，排除了结缔组织疾病患者。将接受远端真腔吻合术（组 T，n=36）的患者与接受双腔吻合术（组 B，n=35）的患者进行比较，比较两组患者的生存率、总体生存率和远端主动脉事件发生率。还研究了远端主动脉（降胸主动脉、肾上腹主动脉和肾下腹主动脉的最大直径）的增长率。组 T 的中位年龄明显高于组 B（T：66 岁比 B：60 岁，P=0.001）。术后组 T 的假腔完全和部分血栓形成率明显高于组 B（完全血栓形成分别为 26.9%比 0%，P=0.01；部分血栓形成分别为 65.4%比 3.9%，P<0.0001）。在 63 例患者（88.7%）的中位随访 6.8 年中，两组患者的生存率、总体生存率和远端主动脉事件无事件生存率以及远端主动脉的增长率均无显著差异。与双腔吻合术相比，慢性 B 型主动脉夹层的远端吻合真腔并未改善中期生存率、主动脉无事件生存率和远端主动脉的增长率。
