Jakob H, Tsagakis K, Dohle D S, Kottenberg E, Konorza T, Janosi R A, Erbel R
Klinik für Thorax- und Kardiovaskuläre Chirurgie, Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
Herz. 2011 Sep;36(6):525-30. doi: 10.1007/s00059-011-3514-8.
With the establishment of a hybrid room 7 years ago, it was possible for the first time to unite a full range of diagnostics and surgical therapy under the sterile conditions of an operating theatre in life-threatening aortic dissection. Thus, the early phase associated with high mortality rates (3%-5% per hour) could be significantly reduced from 8 h to 4 h. Multidisciplinary teams consisting of a cardiac surgeon, a cardiologist and an anaesthetist enable competent and rapid life-saving measures. In the case of acute and persistent visceral and/or peripheral malperfusion over many hours, primary endovascular reconstitution of perfusion precedes delayed surgical replacement of the ascending aorta with or without the aortic arch. Additional strategic and technical surgical developments have helped reduce overall hospital mortality from 15%-20% to 10%-15%. Though expensive to build, a high-technology hybrid room enables interdisciplinary specialization and concentration, as demonstrated by the exponential growth in the development of transcatheter aortic valve implants or the endovascular treatment of aortic disease.
7年前，随着杂交手术室的建立，首次能够在危及生命的主动脉夹层手术的无菌条件下，将全方位的诊断和手术治疗结合起来。因此，与高死亡率（每小时3%-5%）相关的早期阶段可以从8小时显著缩短至4小时。由心脏外科医生、心脏病专家和麻醉师组成的多学科团队能够采取有效且迅速的救生措施。对于急性且持续数小时的内脏和/或外周灌注不良，首先进行灌注的血管内重建，然后再择期对升主动脉进行手术置换，可保留或不保留主动脉弓。其他战略和技术上的手术进展已帮助将总体医院死亡率从15%-20%降至10%-15%。尽管建设成本高昂，但高科技杂交手术室能够实现跨学科的专业化和集中化，经导管主动脉瓣植入术的发展或主动脉疾病的血管内治疗呈指数级增长就证明了这一点。
