A型急性主动脉夹层：为何术后假腔仍保持通畅？
Type A acute aortic dissection: why does the false channel remain patent after surgery?
作者信息
Bing Fabrice, Rodière Mathieu, Martinelli Thomas, Monnin-Bares Valérie, Chavanon Olivier, Bach Vincent, Baguet Jean-Philippe, Ferretti Gilbert R, Thony Frédéric
机构信息
University of Strasbourg, Strasbourg, France.
出版信息
Vasc Endovascular Surg. 2014 Apr;48(3):239-45. doi: 10.1177/1538574413518611. Epub 2014 Jan 14.
PURPOSE
To understand why the false channel (FC) remains patent after surgery of type A acute aortic dissection (TAAAD).
MATERIALS AND METHODS
Postoperative contrast-enhanced computed tomography scans of 129 patients operated for TAAAD were analyzed, and a color-Doppler ultrasound examination (CDUS) of the supra-aortic vessels (SAVs) was performed in 12 patients.
RESULTS
The FC remained patent in 107 (82.9%) patients. The entry site was situated near the distal anastomosis in 43 (40.2%) patients and far from it in 44 (41.1%) patients. In 10 (9.35%) patients, an entry site was observed only in the SAVs. In 10 (9.35%) patients, no entry site was seen. Of the 12 patients explored with CDUS, a retrograde filling of the FC was observed in 11 patients.
CONCLUSION
The frequent postoperative circulating aortic FC can be explained by the persistence of the primary entry tear, the presence of iatrogenic tears, and/or a retrograde filling in the SAVs.
目的
了解A型急性主动脉夹层（TAAAD）手术后假腔（FC）为何仍保持通畅。
材料与方法
分析129例行TAAAD手术患者的术后增强CT扫描结果，并对12例患者的主动脉弓上血管（SAVs）进行彩色多普勒超声检查（CDUS）。
结果
107例（82.9%）患者的FC保持通畅。43例（40.2%）患者的入口位于远端吻合口附近，44例（41.1%）患者的入口远离远端吻合口。10例（9.35%）患者仅在SAVs中观察到入口。10例（9.35%）患者未见入口。在接受CDUS检查的12例患者中，11例观察到FC逆行充盈。
结论
术后常见的循环主动脉FC可由原发入口撕裂的持续存在、医源性撕裂的存在和/或SAVs中的逆行充盈来解释。
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