男性和女性小动脉瘤的升主动脉手术。

Dmitri Panfilov, Victor Saushkin, Svetlana Sazonova, Boris Kozlov
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摘要

引言:根据最近的数据,胸主动脉手术降低了发病率和死亡率,包括升主动脉瘤的治疗;然而,女性术后出现不良后果的风险增加。目的:我们的目的是评估接受先发制人升主动脉置换术(AAR)的男性和女性患者的早期和晚期结果。方法:从2013年1月到2021年9月,91名患者(56名[61.5%]男性和35名[38.5%]女性)接受了AAR治疗,治疗范围为5.0至5.5厘米的小型非综合征动脉瘤。对各组进行了基于倾向评分的调整。我们比较了男性和女性的临床结果。结果:女性术前正常主动脉直径(2.9[2.7;3.2]cm/m2)明显大于男性(2.5[2.3;2.6]cm/m2,P)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Ascending Aortic Surgery for Small Aneurysms in Men and Women.

Introduction: According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes.

Objective: Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR).

Methods: From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females.

Results: Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404).

Conclusion: Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women.

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