Inoue Yosuke, Minatoya Kenji, Oda Tatsuya, Seike Yoshimasa, Tanaka Hiroshi, Sasaki Hiroaki
Gen Thorac Cardiovasc Surg. 2016 Jan;64(1):55-7. doi: 10.1007/s11748-015-0596-x.
Spiral incision of the thoracic wall through the 5th or 6th intercostal space has been a standard approach for thoracoabdominal and descending aorta replacement (Interact Cardiovasc Thorac Surg 18:278–282, 2014). The exposure of the proximal lesion, however, is often insufficient for patients with a flat chest. In this connection, Asian patients tend to have a narrower chest cavity and the flat chest is frequently seen in Marfan syndrome patients. A novel straight incision with rib-cross approach was applied for such a patient with a narrow or flat chest to make aortic repair easier and safer. We herein present a case of a 37-year-old male diagnosed with extensive aortic aneurysm associated with chronic aortic dissection, who underwent one-stage repair of the aortic arch and thoracoabdominal aortic aneurysm via a novel surgical incision.
经第5或第6肋间间隙进行胸壁螺旋切口一直是胸腹主动脉和降主动脉置换的标准方法（《心血管与胸外科交互作用》，2014年第18卷：278 - 282页）。然而，对于胸廓扁平的患者，近端病变的暴露往往不足。就此而言，亚洲患者的胸腔往往较窄，马凡综合征患者中常见胸廓扁平。一种新型的肋骨交叉直切口被应用于胸廓狭窄或扁平的此类患者，以使主动脉修复更容易、更安全。我们在此报告一例37岁男性患者，诊断为广泛主动脉瘤合并慢性主动脉夹层，通过一种新型手术切口接受了主动脉弓和胸腹主动脉瘤的一期修复。
