Colak Necmettin, Nazli Yunus, Alpay Mehmet Fatih, Akkaya Ismail Olgun, Aksoy Omer Nuri, Akgedik Sukran, Cakir Omer
Department of Cardiovasculary Surgery, School of Medicine, Fatih University, Ankara;
Exp Clin Cardiol. 2013 Spring;18(2):166-8.
In the surgical treatment of acute aortic dissection, tissue glues are widely used to reinforce the adhesion between the dissected aortic layers. A new inflatable balloon device was developed to compress the dissected aortic wall during gluing to increase adhesion between the dissected layers. The present study used an ex vivo experimental animal model to test the hypothesis that this device is effective when gluing the true and false channels of dissected aortas.
In the ex vivo experimental model, aortic dissection was simulated surgically on 12 fresh bovine aorta samples. In six samples (group I), the inflatable balloon device was inserted into the aorta to reinforce and fuse the dissected layers during gluing. The other six fresh bovine aortic samples (group II) were compressed between the surgeon's fingers during gluing. Aortic samples were evaluated and compared macroscopically and histologically.
In group I, adhesion between the dissected layers was easily achieved during gluing. All false cavities were perfectly closed, with no deleterious effects related to the device. In group II, the adhesion between the dissected layers was not complete and some false cavities remained patent.
The inflatable balloon device can increase the adhesive effect of tissue glues via homogenous compression of the dissected aortic layers. In addition, the balloon can prevent distal embolization of the glue.
在急性主动脉夹层的外科治疗中,组织胶水被广泛用于加强夹层主动脉各层之间的粘连。研发了一种新型充气式球囊装置,用于在使用胶水时压缩夹层主动脉壁,以增强夹层各层之间的粘连。本研究采用体外实验动物模型来验证该装置在粘合夹层主动脉的真腔和假腔时是否有效的假设。
在体外实验模型中,对12个新鲜牛主动脉样本进行手术模拟主动脉夹层。在6个样本(I组)中,将充气式球囊装置插入主动脉,在使用胶水时加强并融合夹层各层。另外6个新鲜牛主动脉样本(II组)在使用胶水时由外科医生手指进行挤压。对主动脉样本进行宏观和组织学评估及比较。
在I组中,使用胶水时夹层各层之间很容易实现粘连。所有假腔均完美闭合,且未出现与该装置相关的有害影响。在II组中,夹层各层之间的粘连不完全,一些假腔仍保持开放。
充气式球囊装置可通过对夹层主动脉各层进行均匀压缩来增强组织胶水的粘合效果。此外,球囊可防止胶水远端栓塞。