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首页> 外文期刊>The Journal of Thoracic and Cardiovascular Surgery >Complex aortic surgery in a regional center in the United Kingdom. Should the United Kingdom now adopt a United States-style supercenter model?
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Complex aortic surgery in a regional center in the United Kingdom. Should the United Kingdom now adopt a United States-style supercenter model?

机译：英国地区中心的复杂主动脉手术。英国现在应该采用美国式的超级中心模式吗？

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Background: The United States has established aortic supercenters, which have demonstrated clear improvements in the short-term and long-term outcomes after surgery on the thoracic aorta. This model of care does not exist in the United Kingdom.We have looked at our recent experience of emergency and elective thoracic aortic surgery and describe and compare our operative outcomes and 10-year survival with other regional centers and supercenters worldwide.Methods: This was a retrospective analysis of data collected prospectively from our cardiac database on patients who underwent surgery on the thoracic aorta (n = 318) between November 1999 and November 2012. The outcome measures were adjusted operative mortality, postoperative complications, and long-term survival.Results: Type A dissection was carried out on 23.90%of the patients and 76.10%had surgery on the aortic root and thoracic aorta for nondissection. The mean age of the patients was 62.21 ± 14.1 years. The mean logistic EuroSCOREwas 26 in the dissection group and 19 in the nondissection group.Hospital mortality was significantly greater (P < .05) in the dissection group compared with the nondissection group (23.7% vs 12.8%). Survival after dissection and nondissection surgery was 66.3% ± 5.6% versus 77.4% ± 2.8%, respectively, at 3 years, 63.9% ± 5.9% versus 71.8% ± 3.2% at 5 years, and 53.7% ± 7.4% versus 47.1% ± 6.0% at 10 years.Conclusions: Our outcomes are comparable with other regional centers worldwide; however, they are not as good as those reported from the aortic supercenters. There should be continued impetus regarding the establishment of thoracic aortic surgery guidelines and specialist aortic centers in the United Kingdom.
机译：背景：美国已建立了主动脉超级中心，这些中心已显示出对胸主动脉进行手术后短期和长期结局的明显改善。这种护理模式在英国不存在，我们回顾了我们最近进行的急诊和择期胸主动脉手术的经验，并与全球其他区域中心和超级中心描述和比较了我们的手术结果和10年生存率。回顾性分析从我们的心脏数据库中前瞻性收集的1999年11月至2012年11月期间接受胸主动脉手术（n = 318）的患者的数据。结局指标包括手术死亡率，术后并发症和长期生存率。 ：A型清扫术在23.90％的患者中进行，76.10％的患者在主动脉根部和胸主动脉进行了不清扫术。患者的平均年龄为62.21±14.1岁。解剖组的平均逻辑EuroSCORE为26，非解剖组为19.与非解剖组相比，解剖组的医院死亡率显着更高（P <.05）（23.7％vs 12.8％）。 3年时解剖和非解剖手术后的存活率分别为66.3％±5.6％和77.4％±2.8％，5年时分别为63.9％±5.9％和71.8％±3.2％，53.7％±7.4％和47.1％±十年时为6.0％。结论：我们的结果可与全球其他地区中心相媲美;但是，它们不如主动脉超级中心报告的那样好。关于在英国建立胸主动脉手术指南和专业主动脉中心，应继续保持动力。

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