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["'E-vita open plus' 杂交支架移植物植入的单中心经验"]

[Single-centre experience with implantation of the 'E-vita open plus' hybrid stent graft].

作者信息

Kozlov B N, Panfilov D S, Saushkin V V, Kuznetsov M S, Nasrashvili G G, Andriianova A V, Shipulin V M

机构信息

Cardiovascular Surgery Department, Scientific Research Institute of Cardiology, Tomsk, Russia.

出版信息

Angiol Sosud Khir. 2017;23(2):59-63.

Abstract

Hybrid technologies appear to have been gaining ground in surgery of the thoracic aorta. The present study was aimed at assessing the immediate clinical outcomes of surgical treatment of diseases of the thoracic aorta by means of the 'E-vita open plus' hybrid stent graft. The 'E-vita open plus' hybrid stent graft was implanted to 18 patients. All operations were carried out in the conditions of moderate hypothermia. The brain was protected by unilateral cerebral perfusion through the brachiocephalic trunk. The duration of artificial circulation averagely amounted to 265.1 [214; 281] min., with the mean aortic cross-clamping time equalling 150.8 [121; 177] min., and circulatory arrest lasting 55 [47.5; 62.5] min. In one (5.5%) case resternotomy was performed for haemorrhage. Five (27.8%) patients required haemodialysis to perform for postoperative renal insufficiency. A further five (27.8%) patients were found to have transient impairment of cerebral circulation. One (5.5%) patient was diagnosed as having haemorrhage into the area of the 'old ischaemic focus', one (5.5%) patient developed transient spinal ischaemia spontaneously disappearing within the first 24 hours. There were no cases of cardiac complications. A conclusion was drawn that hybrid operations according to the 'frozen elephant trunk' technique yield satisfactory immediate clinical results of treatment in patients with thoracic aortic aneurysms and dissection.

摘要

混合技术似乎在胸主动脉手术中逐渐得到应用。本研究旨在评估采用“E-vita open plus”混合支架型人工血管治疗胸主动脉疾病的近期临床疗效。18例患者植入了“E-vita open plus”混合支架型人工血管。所有手术均在中度低温条件下进行。通过头臂干进行单侧脑灌注以保护大脑。人工循环时间平均为265.1[214; 281]分钟,平均主动脉阻断时间为150.8[121; 177]分钟,循环停止持续55[47.5; 62.5]分钟。1例(5.5%)患者因出血行再次胸骨切开术。5例(27.8%)患者因术后肾功能不全需要进行血液透析。另有5例(27.8%)患者出现短暂性脑循环障碍。1例(5.5%)患者被诊断为“陈旧性缺血灶”区域出血,1例(5.5%)患者出现短暂性脊髓缺血,在最初24小时内自行消失。未发生心脏并发症。得出的结论是,采用“冰冻象鼻”技术的混合手术在胸主动脉瘤和夹层患者中产生了令人满意的近期临床治疗效果。

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