使用离心泵进行部分左心旁路循环修复撕裂的降主动脉。
Repair of the torn descending thoracic aorta using the centrifugal pump for partial left heart bypass.
作者信息
Moore Ernest E, Burch Jon M, Moore John B
机构信息
Denver Health Medical Center University of Colorado Health Sciences Center, Denver, Colorado, USA.
出版信息
Ann Surg. 2004 Jul;240(1):38-43. doi: 10.1097/01.sla.0000129355.74638.00.
OBJECTIVE
To describe the relevant anatomy and sequential technical maneuvers to repair blunt injuries to the descending thoracic aorta with partial left heart bypass.
SUMMARY BACKGROUND DATA
Blunt injury to the descending thoracic aorta remains among the most lethal and morbid of anatomic injuries. Of the techniques of repair which have evolved, "clamp and sew" is simple but has an unacceptable risk of paraplegia. In contrast, partial left heart bypass is more complex but virtually eliminates the risk of paraplegia.
METHOD
We present a detailed management plan for treating blunt injury to the descending thoracic aorta using partial left heart bypass that has evolved over the past 25 years. Preoperative Azā-blockade to reduce the risk of rupture and use of the centrifugal pump to reduce the incidence of paraplegia without the risk of systemic anticoagulation are essential.
RESULTS
We present a detailed description of our management of injuries to the descending thoracic aorta. In our experience, no episodes of postoperative paraplegia have occurred with the use of this technique.
CONCLUSION
Blunt injury to the descending thoracic aorta can be safely repaired using partial left heart bypass.
目的
描述采用部分左心转流修复钝性胸降主动脉损伤的相关解剖结构及连续技术操作。
总结背景资料
钝性胸降主动脉损伤仍然是解剖损伤中最致命和病态的损伤之一。在已发展的修复技术中，“钳夹缝合”简单，但有不可接受的截瘫风险。相比之下，部分左心转流更复杂，但几乎消除了截瘫风险。
方法
我们提出了一种详细的管理计划，用于治疗钝性胸降主动脉损伤，采用部分左心转流，该方法在过去25年中不断发展。术前使用阿扎布阻断以降低破裂风险，并使用离心泵以降低截瘫发生率且无全身抗凝风险至关重要。
结果
我们详细描述了我们对胸降主动脉损伤的处理。根据我们的经验，使用该技术未发生术后截瘫事件。
结论
采用部分左心转流可安全修复钝性胸降主动脉损伤。
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