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[主动脉夹层动脉瘤的实验研究]

[Experimental study on the dissecting aortic aneurysm].

作者信息

Kudo Y

机构信息

Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Hokkaido Igaku Zasshi. 1989 Nov;64(6):683-94.

PMID:2606444
Abstract

Type I dissecting aortic aneurysm is not only the most common type of all but an extremely lethal event. It is important to create the experimental model of type I dissection for clarifying behavior of this disease and successful treatment. The purpose of this study is: (1) production of experimental model of type I aortic dissection; (2) examination of progression manner of dissection; (3) and investigation of influence of dissection upon aortic valve and coronary artery. The experimental model of type I aortic dissection was produced in adult mongrel dogs. Bilateral thoracotomy was made and intimal tear was created in the ascending aorta by modified Blanton's procedure. Hypertension and creation of large pocket of the aortic media were necessary to produce type I aortic dissection. Extension of dissection had a tendency toward the inner layer of the aortic wall at distal site. However, at proximal site the dissection progressed in the same layer of the aortic wall. In this series, retrograde extension of dissection remained blind above annulus of aortic valve, and no incidence of aortic regurgitation or coronary ischemia was occurred. But on histologic examination, degeneration of the aortic wall by the dissection was observed. Such weakness of aortic wall showed potentiality to developed into subsequent aortic regurgitation or coronary ischemia.

摘要

I型主动脉夹层动脉瘤不仅是所有类型中最常见的,而且是极其致命的事件。创建I型夹层的实验模型对于阐明这种疾病的行为和成功治疗非常重要。本研究的目的是:(1)制作I型主动脉夹层的实验模型;(2)检查夹层的进展方式;(3)研究夹层对主动脉瓣和冠状动脉的影响。I型主动脉夹层的实验模型是在成年杂种犬身上制作的。进行双侧开胸手术,并通过改良的布兰顿手术在升主动脉造成内膜撕裂。高血压和形成大的主动脉中膜腔隙是产生I型主动脉夹层所必需的。夹层的延伸在远端部位有向主动脉壁内层发展的趋势。然而,在近端部位,夹层在主动脉壁的同一层中进展。在本系列中,夹层的逆行延伸在主动脉瓣环上方仍为盲端,未发生主动脉反流或冠状动脉缺血事件。但在组织学检查中,观察到夹层导致的主动脉壁变性。这种主动脉壁的薄弱显示出发展为后续主动脉反流或冠状动脉缺血的可能性。

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