Mochizuki Yoshihiko, Iida Hiroshi, Mori Hideaki, Yamada Yasuyuki, Miyoshi Shinichiro
Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Tochigi, Japan.
Tex Heart Inst J. 2003;30(2):128-9.
We used left common carotid artery cannulation for repair of type A aortic dissection in 2 patients for whom both femoral artery and axillary artery cannulation were thought to be more dangerous, due to dissection of the brachiocephalic trunk and left subclavian artery in association with abdominal stenosis. Before performing end-to-side anastomosis, we attached a small partial clamp to the left common carotid artery, thereby maintaining adequate cerebral blood flow during perfusion. To date, neither of our patients has experienced neurologic complications related to this procedure. We believe that left common carotid artery cannulation for type A dissections is useful when dissection of the brachiocephalic trunk and left subclavian artery is found in association with abdominal or femoral artery stenosis. To the best of our knowledge, these 2 cases are the 1st described in the medical literature.
我们对2例A型主动脉夹层患者采用左颈总动脉插管进行修复，这2例患者因头臂干和左锁骨下动脉夹层合并腹部狭窄，被认为股动脉和腋动脉插管风险更高。在进行端侧吻合之前，我们在左颈总动脉上夹上一个小型局部血管夹，从而在灌注过程中维持充足的脑血流量。迄今为止，我们的这2例患者均未出现与该操作相关的神经系统并发症。我们认为，当发现头臂干和左锁骨下动脉夹层合并腹部或股动脉狭窄时，对A型夹层采用左颈总动脉插管是有用的。据我们所知，这2例病例是医学文献中首次报道的。
