Lentini Salvatore, Savasta Marcello, Ciuffreda Francesco, La Monaca Marco, Gaeta Roberto
Cardiac Surgery Unit and Perfusion Service, Policlinico G. Martino, University of Messina, Messina, Italy.
J Extra Corpor Technol. 2009 Jun;41(2):114-8.
During surgery for acute type A aortic dissection, malperfusion may occur during cardiopulmonary bypass. Retrograde perfusion trough femoral cannulation is considered a predisposing factor. However, this may occur even with antegrade perfusion, because of the presence of multiple flaps or compression of the true lumen by the false lumen. In this particular setting, the aim is to reach a perfusion of the true lumen of the dissected aorta. A technique of epicardial ultrasound-guided direct cannulation of the dissected aorta's true lumen by a Seldinger technique may help in those cases. We describe the technique with particular interest to the epicardial ultrasound control and the type of arterial cannula to be inserted by the Seldinger technique.
在急性A型主动脉夹层手术期间，体外循环过程中可能会发生灌注不良。经股动脉插管逆行灌注被认为是一个诱发因素。然而，即使采用顺行灌注，由于存在多个内膜瓣或假腔对真腔的压迫，这种情况也可能发生。在这种特殊情况下，目标是实现对夹层主动脉真腔的灌注。一种通过Seldinger技术在心脏超声引导下直接插管至夹层主动脉真腔的技术可能有助于处理这些病例。我们将特别关注心脏超声控制以及通过Seldinger技术插入的动脉插管类型来描述该技术。
