Emrecan Bilgin, Durna Firat, Girgin Serkan, Alshalaldeh Mohammed
Department of Cardiovascular Surgery, Pamukkale University, Denizli, Turkey.
Kardiochir Torakochirurgia Pol. 2014 Jun;11(2):132-5. doi: 10.5114/kitp.2014.43838. Epub 2014 Jun 29.
Different arterial inflow sites have been reported to date for particularly challenging cardiac operations. The ascending aorta, femoral artery, and subclavian artery are the most commonly used sites. Although its use has been reported, the aortic arch has not gained popularity in the performance of cannulation. According to a search performed in the PubMed database, aortic arch cannulation for ascending aorta replacement has not been examined in a separate study before. In the present study, we report the treatment outcomes of patients with ascending aortic aneurysms in whom the aortic arch was cannulated for arterial inflow.
Twenty-seven patients with aneurysmal dilatation of the ascending aorta underwent ascending aorta replacement from April 2010 to March 2013. The mean age of the patients was 64 years. All operations were carried out by cannulating the aortic arch distally from the origin of the innominate artery.
There was no mortality or cannulation-related morbidity. In 23 patients, only the supracoronary ascending aorta was replaced, whereas in 4 patients, the button modification of the Bentall procedure was performed to replace the root and the ascending aorta.
The technique of aortic arch cannulation distal to the origin of the innominate artery is worthy of consideration in the treatment of aneurysms limited to the ascending aorta due to its safety, simplicity, and low morbidity.
迄今为止,已有报道称在一些极具挑战性的心脏手术中采用了不同的动脉流入部位。升主动脉、股动脉和锁骨下动脉是最常用的部位。尽管主动脉弓插管的应用已有报道,但在插管操作中尚未得到广泛应用。根据在PubMed数据库中进行的检索,此前尚无单独研究对升主动脉置换术中的主动脉弓插管进行过探讨。在本研究中,我们报告了对升主动脉瘤患者进行主动脉弓插管以实现动脉流入的治疗结果。
2010年4月至2013年3月期间,27例升主动脉瘤样扩张患者接受了升主动脉置换术。患者的平均年龄为64岁。所有手术均通过从无名动脉起始部向远端插管至主动脉弓来进行。
无死亡病例或与插管相关的并发症。23例患者仅进行了冠状动脉上方升主动脉的置换,而4例患者则采用了Bentall手术的纽扣式改良术来置换主动脉根部和升主动脉。
无名动脉起始部远端的主动脉弓插管技术因其安全性、简便性和低并发症发生率,在治疗仅限于升主动脉的动脉瘤时值得考虑。