Wong Randolph Hl, Ho Jacky Yk, Underwood Malcolm J
Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong
Asian Cardiovasc Thorac Ann. 2016 Jun;24(5):496-501. doi: 10.1177/0218492316643844. Epub 2016 Apr 11.
Conventionally, aortic pathologies involving the ascending, arch, and descending thoracic aorta are treated by a staged operation. The Thoraflex device is a composite 4-branched graft with a distal endovascular stent, which allows one-stage treatment of these pathologies. We describe our multimodality hybrid approach for total arch replacement using the Thoraflex device with the adjunct of intraoperative 3-dimensional transesophageal echocardiography, Endo-EYE endoscopy, and on-table aortography in a hybrid operating room. These multimodality assessments can ascertain adequate sealing of a distal aortic tear and proper opening of the endograft, and provide on-table functional assessment of false lumen hemodynamics. Early results are promising.
传统上，累及升主动脉、主动脉弓和降主动脉的主动脉病变采用分期手术治疗。Thoraflex装置是一种带有远端血管内支架的复合四分支移植物，可对这些病变进行一期治疗。我们描述了在杂交手术室中使用Thoraflex装置并辅以术中三维经食管超声心动图、Endo-EYE内镜检查和术中主动脉造影进行全弓置换的多模式杂交方法。这些多模式评估可以确定主动脉远端撕裂的充分封闭和腔内移植物的正确打开，并提供术中假腔血流动力学的功能评估。早期结果很有前景。
