Suliman Amna, Dialynas Michael, Ashrafian Hutan, Bicknell Colin, Mireskandari Maziar, Hamady Mohamad, Athanasiou Thanos
Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK.
J Cardiothorac Surg. 2010 Jan 28;5:4. doi: 10.1186/1749-8090-5-4.
Acute type A aortic dissection can be complicated by visceral malperfusion and is associated with a significant surgical morbidity and mortality. We describe a case of successful management of a complex acute type A dissection with mesenteric and lower limb ischemia treated with endovascular thoracic stenting and femoro-femoral crossover bypass grafting followed by aortic arch repair. To accomplish this, we applied a staged therapeutic approach using serial lactate measurements to assess the adequacy of peripheral perfusion and metabolic status prior to surgical repair of the proximal dissection.
急性A型主动脉夹层可并发内脏灌注不良，并伴有显著的手术发病率和死亡率。我们描述了一例复杂急性A型夹层伴肠系膜和下肢缺血的成功治疗病例，采用血管腔内胸主动脉支架置入术和股-股交叉旁路移植术，随后进行主动脉弓修复。为实现这一目标，我们采用了分阶段治疗方法，在近端夹层手术修复前，通过连续测量乳酸水平来评估外周灌注和代谢状态是否充足。
