Open surgical repair for chronic type B aortic dissection: a systematic review.

摘要: Background: The treatment of chronic type B aortic dissection (CBAD) remains complicated. Thoracic endovascular repair (TEVAR) has supplanted open surgical (OSR) as the preferred for CBAD. Despite TEVAR’s superior short-term results, much less is understood about its long-term outcomes. As understanding OSR originates from historical report, contemporary series, with modern techniques and technologies, may present an alternative to TEVAR. systematic review will assess short- outcomes historic series CBAD. Methods: Electronic searches were performed using six databases their inception March 2014. Relevant studies OSRs identified. Data extracted by two independent reviewers analyzed according predefined clinical endpoints. Studies sub-classified into pre-endovascular (historic series) era (contemporary depending on whether majority cases after 1999. Results: Nineteen identified inclusion quantitative analysis. Pooled mortality was 11.1% overall, 7.5% in nine studies. Stroke, spinal cord ischemia, renal dysfunction, reoperation bleeding 5.9%, 4.9%, 8.1%, respectively, series. Absolute late reintervention 13.3% patients 11.3% Aggregated survival at 1-, 3-, 5-, 10-years all 82.1%, 74.1%, 66.3%, 50.8%, respectively. Conclusions: offers acceptable results. Management approaches should be considered carefully, taking account both complications. More research required determine indications TEVAR dissections.