Hamiko Marwan, Jahnel Katja, Rogaczewski Julia, Schafigh Myriam, Silaschi Miriam, Spaeth Andre, Velten Markus, Roell Wilhelm, Ahmad Ali El-Sayed, Bakhtiary Farhad
Department of Cardiac Surgery, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany.
J Clin Med. 2023 Jul 5;12(13):4498. doi: 10.3390/jcm12134498.
(1) Background: Despite optimal surgical therapy, replacement of the ascending aorta leads to a significant reduction in the quality of life (QoL). However, an optimal result includes maintaining and improving the QoL. The aim of our study was to evaluate the long-term outcome and the QoL in patients with aneurysms in the ascending aorta; (2) Methods: Between 2014 and 2020, 121 consecutive patients who underwent replacement of the ascending aorta were included in this study. Acute aortic pathologies were excluded. A standard short form (SF)-36 questionnaire was sent to the 112 survivors. According to the surgical procedure, patients were divided into two groups (A: supracoronary replacement of the aorta, n = 35 and B: Wheat-, David- or Bentall-procedures, n = 86). The QoL was compared within these groups and to the normal population, including myocardial infarction (MI), coronary artery disease (CAD) and cancer (CAN) patients; (3) Results: 83 patients were males (68.6%) with a mean age of 62.0 ± 12.5 years. Early postoperative outcomes showed comparable results between groups A and B, with a higher re-thoracotomy rate in B (A: 0.0% vs. B: 22.1%, = 0.002). The 30-day mortality was zero. Overall, mortality during the follow-up was 7.4%. The SF-36 showed a significant decay in both the Physical (PCS) and Mental Component Summary (MCS) in comparison to the normal population (PCS: 41.1 vs. 48.4, < 0.001; MCS: 42.1 vs. 50.9, < 0.001) but without significant difference between both groups. Compared to the MI and CAD patients, significantly higher PCS but lower MCS scores were detected ( < 0.05); (4) Conclusions: Replacement of the ascending aorta shows low risk regarding the operative and postoperative outcomes with satisfying long-term results in the QoL. The extent of the surgical procedure does not influence the postoperative QoL.
(1) 背景：尽管进行了最佳手术治疗，但升主动脉置换术会导致生活质量（QoL）显著下降。然而，理想的结果应包括维持和改善生活质量。本研究的目的是评估升主动脉瘤患者的长期预后和生活质量；(2) 方法：2014年至2020年期间，121例连续接受升主动脉置换术的患者纳入本研究。排除急性主动脉病变。向112名幸存者发送了标准简短形式（SF）-36问卷。根据手术方式，患者分为两组（A组：主动脉冠状动脉上置换术，n = 35；B组：Wheat、David或Bentall手术，n = 86）。对这些组内以及与正常人群（包括心肌梗死（MI）、冠状动脉疾病（CAD）和癌症（CAN）患者）的生活质量进行比较；(3) 结果：83例患者为男性（68.6%），平均年龄62.0±12.5岁。术后早期结果显示A组和B组之间结果相当，B组再次开胸率较高（A组：0.0% vs. B组：22.1%，P = 0.002）。30天死亡率为零。总体而言，随访期间死亡率为7.4%。SF-36显示，与正常人群相比，身体（PCS）和精神成分总结（MCS）均显著下降（PCS：41.1 vs. 48.4，P < 0.001；MCS：42.1 vs. 50.9，P < 0.001），但两组之间无显著差异。与MI和CAD患者相比，检测到PCS显著更高但MCS得分更低（P < 0.05）；(4) 结论：升主动脉置换术在手术和术后结果方面风险较低，生活质量的长期结果令人满意。手术方式的范围不影响术后生活质量。
