Myrmel T, Robertsen S, Almdahl S M, Dahl P E, Lie M, Sørlie D
Department of Surgery, University Clinic, Tromsø, Norway.
Scand J Thorac Cardiovasc Surg. 1995;29(3):105-9. doi: 10.3109/14017439509107214.
The surgical mortality among 22 patients treated for thoracic or thoracoabdominal aneurysm was compared with the mortality in 47 patients managed without surgery. Surgical mortality ( < 30 days) was low (1/13) in ascending aortic aneurysm, but higher (3/8) in aneurysm of the descending or thoracoabdominal aorta (including both acute and elective operations). Of the 20 non-surgically managed patients in the latter group, 15 died after a mean of 1.1 year. The only patient operated on for aortic arch aneurysm died of cerebral ischaemia 2 days postoperatively. Most of the 19 non-operated patients with aneurysm of the arch or total aorta (mean age 76 years) were never considered for surgical treatment. The analysis supports aggressive management of patients with aneurysm of the ascending, descending or thoracoabdominal aorta. Many of our patients with aneurysm of the arch or involving most of the aorta were old and had other, concomitant diseases, and in such cases an aggressive treatment strategy does not seem justified.
对22例接受胸主动脉或胸腹主动脉瘤治疗的患者的手术死亡率与47例未接受手术治疗的患者的死亡率进行了比较。升主动脉瘤的手术死亡率（<30天）较低（1/13），但降主动脉或胸腹主动脉瘤的手术死亡率较高（3/8）（包括急诊和择期手术）。在后一组未接受手术治疗的20例患者中，15例在平均1.1年后死亡。唯一接受主动脉弓动脉瘤手术的患者术后2天死于脑缺血。19例未接受手术治疗的主动脉弓或全主动脉瘤患者（平均年龄76岁）中的大多数从未考虑过手术治疗。该分析支持对升主动脉、降主动脉或胸腹主动脉瘤患者进行积极治疗。我们的许多主动脉弓瘤或累及大部分主动脉的患者年龄较大且患有其他合并症，在这种情况下，积极的治疗策略似乎不合理。
