Sasaguri S, Fukuda T, Hayashi I, Yamamoto T, Yamamoto S, Hosoda Y
Department of Thoracic and Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 1999 Apr;47(4):158-62. doi: 10.1007/BF03217962.
Antero-axillary thoracotomy--a new approach for the reconstruction of the aortic arch--provides a wide view of the arch and makes accessible the superior vena cava for retrograde cerebral perfusion as well as the coronary sinus for retrograde infusion of cardioplegia. This procedure has been used over 22 months for 26 patients with aortic arch aneurysm or aortic dissection, and the surgical results were evaluated. The distal arch was replaced in 16 patients, the total arch in 9 patients, and the proximal arch in 1 patient, using this technique. The mean duration of deep hypothermic circulatory arrest was 38 min, and the hospital mortality was 15.4%. Antero-axillary thoracotomy may be an excellent approach for the reconstruction of the aortic arch, minimizing the duration of hypothermic circulatory arrest.
腋前胸廓切开术——一种重建主动脉弓的新方法——可提供主动脉弓的广阔视野，并能显露上腔静脉以便进行逆行脑灌注，以及显露冠状静脉窦以便进行逆行心脏停搏液灌注。该手术方法已在22个月内应用于26例主动脉弓瘤或主动脉夹层患者，并对手术结果进行了评估。采用该技术，16例患者行远端主动脉弓置换，9例患者行全主动脉弓置换，1例患者行近端主动脉弓置换。深低温循环停搏的平均持续时间为38分钟，医院死亡率为15.4%。腋前胸廓切开术可能是重建主动脉弓的一种极佳方法，可将低温循环停搏的持续时间降至最低。
