Masuda M, Mogi K, Nakaya M, Pearce Y, Imamaki M, Shimura H, Okada Y, Nishimura K, Nakajima N
First Department of Surgery, Chiba University School of Medicine, Japan.
Surg Today. 2001;31(2):108-12. doi: 10.1007/s005950170192.
The median sternotomy approach for the treatment of chronic pulmonary thromboembolism was recently improved by Daily, Jamieson, and coworkers who adopted it for use under cardiopulmonary bypass with intermittent circulatory arrest; however, we have sometimes found that the circulatory arrest time was too short to complete thromboendarterectomy. Therefore, we attempted to perform a selective cerebral perfusion technique to extend the endarterectomy time. Although we noted slight back-bleeding from the bronchial arteries, we were able to extend the endarterectomy time without causing any postoperative delirium. We conclude that the median sternotomy approach using cardiopulmonary bypass with selective cerebral perfusion may be the best option for extending the thromboendarterectomy time.
最近，戴利、贾米森及其同事改进了用于治疗慢性肺血栓栓塞的正中胸骨切开术方法，他们采用该方法在体外循环和间歇性循环停止的情况下进行手术；然而，我们有时发现循环停止时间过短，无法完成血栓内膜切除术。因此，我们尝试采用选择性脑灌注技术来延长内膜切除术时间。尽管我们注意到支气管动脉有轻微回血，但我们能够延长内膜切除术时间，且未引起任何术后谵妄。我们得出结论，采用体外循环和选择性脑灌注的正中胸骨切开术方法可能是延长血栓内膜切除术时间的最佳选择。
