TEVAR 术后移植物感染合并主动脉食管瘘的手术治疗:一项回顾性单中心单臂研究。

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-09-20 DOI:10.1186/s13019-024-03109-8
Shanshan Jin, Gonghe Wei, Xiangrui Qu, Wenrui Li
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引用次数: 0

摘要

目的:继发于胸主动脉血管内修复术(TEVAR)的主动脉食管瘘(AEF)是一种罕见的致命疾病。作者报告了 10 例 TEVAR 移植感染合并主动脉食管瘘患者的治疗方法和结果:对2018年3月至2024年3月期间10例TEVAR术后继发AEF和移植物感染患者的临床资料进行回顾性分析:围手术期死亡率为70%。2名患者仅进行了TEVAR手术,均死于出血和感染。8名患者接受了开放手术,5人在30天内死亡,其中4人死于大出血,1人死于术后严重感染。3 名患者恢复良好并出院。一名患者在出院 3 个月后死于严重肺炎,两名患者分别存活了 6 年和 3 个月:结论:TEVAR术后,解剖外旁路重建治疗移植物感染合并主动脉食管瘘是可行的,但对大多数患者来说效果不佳。只有经过严格筛选的患者才能接受这种手术,而且要在有经验的中心进行。
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Surgical treatment of graft infection combined with aortoesophageal fistula after TEVAR: a retrospective single-center, single-arm study.

Objective: Aortoesophageal fistula (AEF) secondary to thoracic aortic endovascular repair (TEVAR) is rare and fatal. The author reports the treatment methods and outcomes of 10 patients with a TEVAR graft infection and an aortoesophageal fistula.

Method: A retrospective analysis was conducted on the clinical data of 10 patients who developed a secondary AEF and a graft infection after TEVAR from March 2018 to March 2024.

Result: The perioperative mortality rate was 70%. Two patients had TEVAR only and all died of bleeding and infection. Eight patients underwent open surgery, five died within 30 days, four of them died due to massive bleeding, the one patient died of a serious infection after surgery. Three patients recovered well and were discharged. One patient died of severe pneumonia 3 months after discharge, and two patients survived for 6 years and 3 months, respectively.

Conclusion: Extra-anatomical bypass reconstruction is feasible for treating graft infection combined with aortoesophageal fistula after TEVAR but related to bad outcomes in most of the patients. It is reserved for highly select patients and is performed at centers with experience with this procedure.

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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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