Seki Tatsuya, Maruyama Ryushi, Inoue Yousuke, Hatta Eiichirou, Yamada Akira, Nakanishi Katsuhiko, Sakai Keisuke
Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan.
Kyobu Geka. 2012 Mar;65(3):184-8.
Establishment of cardiopulmonary bypass for Stanford type A acute aortic dissection( type A AAD) should be quick and safe. The femoral artery, axillary artery, ascending aorta, and left ventricular apex are potential access points for cannulation. The most important reason for establishing cardiopulmonary bypass for type A AAD is to allow antegrade blood flow through the true lumen. Starting in 2007, Jakob et al, and Inoue et al. applied the technique of ascending aortic cannulation for type A AAD. From 2008, we applied this method of ascending aorta cannulation in 8 patients and compared preoperative, operative, and postoperative data with a control group, or the femoral artery cannulation group. Ascending aorta cannulation was done safely and easily with the use of the Seldinger technique under epiaortic color Doppler echography and transesophageal echography. No cerebral events or hypoperfusion-based complications occurred in the group of ascending aorta cannulation. Given that no cases of complication occurred using this method, it could be considered as an effective choice of cannulation for cardiopulmonary bypass.
对于 Stanford A 型急性主动脉夹层(A型 AAD),建立体外循环应迅速且安全。股动脉、腋动脉、升主动脉和左心室心尖是潜在的插管部位。为 A 型 AAD 建立体外循环的最重要原因是使顺行血流通过真腔。从 2007 年起,雅各布等人以及井上等人将升主动脉插管技术应用于 A 型 AAD。自 2008 年起,我们将这种升主动脉插管方法应用于 8 例患者,并将术前、术中及术后数据与对照组(即股动脉插管组)进行比较。在主动脉弓上彩色多普勒超声和经食管超声引导下,使用 Seldinger 技术安全、轻松地完成了升主动脉插管。升主动脉插管组未发生脑部事件或基于灌注不足的并发症。鉴于使用该方法未发生并发症,它可被视为体外循环插管的一种有效选择。