Ahmadi Seyed-Hossein, Movahed Nader, Abbasi Kioumars, Soltaninia Hassan, Amirzadegan Ali-Reza, Najafi Mehdi, Shirani Shapoor, Marzban Mehrab, Karimi Abbas-Ali, Mirhoseini Seyed-Jalil, Sanatkarfar Mehdi
Department of Cardiovascular surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2006 Oct;9(4):429-32.
Aortic false aneurysm is a rare complication of surgery of the aorta that can occur several months to years after the initial operation. We reviewed our results with false aneurysm repair using deep hypothermia and circulatory arrest. Three patients were reoperated for false aneurysm of the ascending aorta. Femorofemoral cardiopulmonary bypass with a heparinized system was used in all patients. Hypothermic circulatory arrest at an average temperature of 20 degrees C was instituted in all patients for repair. Two patients had a patch repair with pericardium, and the other one had primary repair of the defect. All patients had false aneurysms in the ascending aorta at the site of a previous aortotomy. Two patients had proven infection as the cause. The mean cardiopulmonary bypass time was 183 +/- 20 minutes, and the mean circulatory arrest time was 35 minutes. Operative mortality was not seen. The mean time for extubation in survivors was 10 - 12 hours, and the average time to discharge was 26 days. Aortic false aneurysms can be safely approached using femorofemoral cardiopulmonary bypass, hypothermic circulatory arrest, and patch repair with acceptable operative mortality and long-term survival.
主动脉假性动脉瘤是主动脉手术罕见的并发症,可在初次手术后数月至数年发生。我们回顾了采用深低温停循环修复假性动脉瘤的结果。3例患者因升主动脉假性动脉瘤接受再次手术。所有患者均使用肝素化系统的股-股心肺转流。所有患者均在平均20℃体温下进行低温停循环以实施修复。2例患者采用心包补片修补,另1例患者对缺损进行直接修补。所有患者的假性动脉瘤均位于既往主动脉切开处的升主动脉。2例患者经证实病因是感染。平均体外循环时间为183±20分钟,平均停循环时间为35分钟。未出现手术死亡。存活患者拔管的平均时间为10 - 12小时,平均出院时间为26天。采用股-股心肺转流、低温停循环及补片修补可安全处理主动脉假性动脉瘤,手术死亡率可接受,患者长期存活。