Sun L Z, Li J R
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
Zhonghua Wai Ke Za Zhi. 2017 Apr 1;55(4):241-244. doi: 10.3760/cma.j.issn.0529-5815.2017.04.001.
In recent 20 years, the rapid development of acute Stanford type A aortic dissection in China has been mainly due to three aspects: (1) the refined classification of aortic dissection based on Stanford classification, (2) right axillary artery canal and selective cerebral perfusion technology become basic cardiopulmonary bypass strategy for Stanford type A aortic dissection, and (3) total aortic arch replacement and descending aortic stent graft surgery (Sun's surgery) become the standard treatment of Stanford type A aortic dissection. However, there are still many problems in the diagnosis and treatment of aortic dissection in China, such as: (1) unstandardized, lack of comprehensive guidelines of aortic dissection, (2) immature, perioperative organ protection and intraoperative blood protection technology remains a big flaw, and (3) it takes a long time to get patient prepared for surgery. In conclusion, as to the issue of the management of acute Stanford type A aortic dissection, there will be a long way for Chinese doctors to go. Peers should pay more attention to this problem and take more efforts, so that the outcome of acute Stanford type A aortic dissection surgical patients can be improved.
近20年来,急性Stanford A型主动脉夹层在中国快速发展,主要得益于三个方面:(1)基于Stanford分类的主动脉夹层精细化分型;(2)右腋动脉插管及选择性脑灌注技术成为Stanford A型主动脉夹层的基本体外循环策略;(3)全主动脉弓置换及降主动脉支架象鼻手术(孙氏手术)成为Stanford A型主动脉夹层的标准治疗方式。然而,中国主动脉夹层的诊治仍存在诸多问题,比如:(1)不规范,缺乏主动脉夹层综合指南;(2)不成熟,围手术期器官保护及术中血液保护技术仍存在较大缺陷;(3)患者术前准备时间长。总之,对于急性Stanford A型主动脉夹层的治疗问题,中国医生还有很长的路要走。同行应更加关注这个问题并付出更多努力,以使急性Stanford A型主动脉夹层手术患者的预后得到改善。