Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Eur J Cardiothorac Surg. 2023 Oct 4;64(4). doi: 10.1093/ejcts/ezad338.
Although recent studies and guidelines suggest the preferred outcomes after surgical repair of thoracic aortic aneurysm (TAA) and thoracoabdominal aortic aneurysm (TAAA), published results are limited to those from high-volume hospitals and based on old data gathered before optimal management was established. Here, we analysed our outcomes over the previous 10 years from cases of open TAA and TAAA repair to offer updated and real-world results of those complex procedures performed in a high-volume centre.
From November 2013 to April 2022, 212 consecutive adult patients who underwent open TAA and TAAA repair were enrolled. We analysed early and late outcomes after surgery, including postoperative complications and mortality.
There were 154 (73%) men, and the median age at surgery was 61 years. Intraoperative death occurred in 1 patient due to uncontrolled bleeding. Nine patients (4%) died during follow-up, and the survival estimates at 5 years were 94 ± 3% and 95 ± 3% after descending TAA and TAAA repair, respectively. Ten patients (4%) suffered from spinal cord ischaemic injury (9 with paraplegia and 1 with paresthesia), but permanent paraplegia persisted in only 1 case.
We report very low postoperative complication rates and excellent early and late survival rates after open TAA and TAAA repair from our recent 10-year data analysis. These findings may assist when choosing treatment options for these complicated diseases.
尽管最近的研究和指南建议了胸主动脉瘤(TAA)和胸腹主动脉瘤(TAAA)手术修复后的首选结果,但已发表的结果仅限于来自高容量医院的结果,并且基于在建立最佳治疗方法之前收集的旧数据。在这里,我们分析了我们在过去 10 年中进行的开放 TAA 和 TAAA 修复的结果,以提供在高容量中心进行的这些复杂手术的最新和真实世界的结果。
从 2013 年 11 月到 2022 年 4 月,连续纳入了 212 例接受开放 TAA 和 TAAA 修复的成年患者。我们分析了手术后的早期和晚期结果,包括术后并发症和死亡率。
共有 154 例(73%)为男性,手术时的中位年龄为 61 岁。1 例患者因无法控制的出血而术中死亡。9 例患者(4%)在随访期间死亡,5 年生存率分别为降 TAA 和 TAAA 修复后 94±3%和 95±3%。10 例(4%)患者发生脊髓缺血性损伤(9 例截瘫,1 例感觉异常),但仅有 1 例持续截瘫。
我们根据最近 10 年的数据分析报告了开放 TAA 和 TAAA 修复后的术后并发症发生率非常低,早期和晚期生存率非常高。这些发现可能有助于在选择这些复杂疾病的治疗方案时提供参考。