采用冷冻象鼻技术对马方综合征合并急性主动脉夹层进行主动脉延长修复术。
Extended aortic repair using frozen elephant trunk technique for Marfan syndrome with acute aortic dissection.
作者信息
Uchida Naomichi, Katayama Akira, Kuraoka Masatsugu, Katayama Keijiro, Takahashi Shinya, Takasaki Taiichi, Sueda Taijiro
机构信息
Division of Surgery, Hiroshima University, Hiroshima, Japan.
出版信息
Ann Thorac Cardiovasc Surg. 2013;19(4):279-82. doi: 10.5761/atcs.oa.12.01930. Epub 2012 Nov 30.
PURPOSE
The aim of this study was to analyze midterm results of frozen elephant trunk technique for Marfan syndrome with acute aortic dissection.
METHODS
Between February 1999 and August 2011 we performed arch replacement uisng frozen elephant trunk technique for acute aortic dissection in 8 patients with Marfan syndrome containing two complicated type B dissections and six type A dissections.Five patients compromised annulo-aortic ectasia who performed Bentall operation.
RESULTS
No patients died in the initial operation. Fate of false lumen on the stent graft border was expressed by CT scan follow-up that were patent in 0, thrombosis in 5 and absorption in 3 patients. One patient who had new aortic dissection 8 years after initial surgery required the Crawford V operation. Ten-years-survival rate was 100% and ten years-event free rate was 67%.
CONCLUSIONS
Frozen elephant trunk technique was feasible for Marfan syndrome with acute aortic dissection and might become alternative prophylactic treatment to the downstream aorta for acute aortic dissection.
目的
本研究旨在分析采用冰冻象鼻技术治疗马凡综合征合并急性主动脉夹层的中期结果。
方法
1999年2月至2011年8月，我们对8例马凡综合征合并急性主动脉夹层患者采用冰冻象鼻技术行主动脉弓置换术，其中包括2例复杂B型夹层和6例A型夹层。5例合并主动脉瓣环扩张的患者接受了Bentall手术。
结果
初次手术无患者死亡。通过CT扫描随访观察支架移植物边缘假腔的转归，结果显示：0例通畅，5例血栓形成，3例吸收。1例患者在初次手术后8年发生新的主动脉夹层，需要接受Crawford V手术。10年生存率为100%，10年无事件生存率为67%。
结论
冰冻象鼻技术治疗马凡综合征合并急性主动脉夹层是可行的，可能成为急性主动脉夹层降主动脉预防性治疗的替代方法。
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