https://scholars.lib.ntu.edu.tw/handle/123456789/471125
標題: | Outcome of medical and surgical treatment in patients with acute type B aortic dissection | 作者: | RON-BIN HSU YI-LWUN HO Chen R.J. SHOEI-SHEN WANG Lin F.-Y. Chu S.-H. |
公開日期: | 2005 | 出版社: | Elsevier USA | 卷: | 79 | 期: | 3 | 起(迄)頁: | 790-794 | 來源出版物: | Annals of Thoracic Surgery | 摘要: | Background. Optimal treatment of acute type B aortic dissection remain unclear. The aim of this study was to assess the clinical outcome of acute type B aortic dissection. Methods. In the last 8 years, 107 patients were admitted for acute type B aortic dissection. We medically treated patients at the time of onset with antihypertensives. Surgery was considered if there is intractable pain, uncontrolled hypertension, severe aortic branch malperfusion, or aneurysm expansion. Results. Twenty-nine patients had pleural effusion (27%), 9 patients had leg ischemia (8%), 5 patients had impending rupture, and 2 patients had aneurysm enlargement exceeding 60 mm on repeated imaging studies. A total of 16 patients (15%) underwent surgical intervention: 8 extra-anatomical bypass for leg ischemia, 1 in situ infrarenal aortoiliac bypass for distal aortic obstruction, and 7 thoracic aortic graft replacement. Of the 8 patients with extra-anatomic bypass, 3 patients died: 2 patients died of catastrophic aortic rupture 2 and 9 days after bypass, and 1 patient died of dissection progression to type A lesion 9 days after bypass. There was no in-hospital death in 92 medically treated patients. Follow-up was 92% complete. The mean follow-up duration was 36.1 months (range, 2 to 96 months). The 6-month, 1-year, and 5-year survival rates of all patients were 96.2 ± 1.9%, 95.2% ± 2.1%, and 95.2% ± 2.1%. Conclusions. Medical treatment of acute type B aortic dissection produced good outcomes. Central aortic procedures such as aortic fenestration and endovascular stenting should be the preferred methods to treat patients with acute type B aortic dissection and leg ischemia because there was high risk of central aortic complications after extra-anatomic bypass. ? 2005 by The Society of Thoracic Surgeons. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-14244261343&doi=10.1016%2fj.athoracsur.2004.07.061&partnerID=40&md5=607c14e14fc34c45ccbd37a3a51eaff1 https://scholars.lib.ntu.edu.tw/handle/123456789/471125 |
ISSN: | 0003-4975 | DOI: | 10.1016/j.athoracsur.2004.07.061 | SDG/關鍵字: | antihypertensive agent; acute disease; adult; aged; aneurysm; aorta disease; aorta dissection; aorta occlusion; aorta rupture; article; bypass surgery; cause of death; clinical feature; controlled study; disease classification; disease severity; female; follow up; hospital admission; human; hypertension; imaging; intractable pain; leg ischemia; major clinical study; male; pleura effusion; priority journal; rupture; surgical technique; survival rate; treatment outcome |
顯示於: | 醫學系 |
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