胸骨上主动脉瓣置换术：关键技术与技巧
Suprasternal Aortic Valve Replacement: Key Technology and Techniques.
作者信息
Kiser Andy C, Caranasos Thomas G, Peterson Mark D, Buller Christopher E, Borger Michael A
机构信息
East Carolina Heart Institute, East Carolina University, Greenville, North Carolina.
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
出版信息
Ann Thorac Surg. 2017 Oct;104(4):1417-1422. doi: 10.1016/j.athoracsur.2017.04.032.
PURPOSE
Suprasternal transcatheter aortic valve replacement offers patients, with unsuitable femoral artery anatomy, an alternative to transapical, direct aortic, and subclavian approaches.
DESCRIPTION
The Transit System (Aegis Surgical, Galway, Ireland) enables transcatheter aortic valve replacement directly into the ascending aorta or innominate artery through a small, suprasternal incision. The valve introducer sheath is inserted through a standard pursestring suture, which facilitates secure arterial closure. The proximity to the aortic valve promotes precise control.
EVALUATION
Proper patient selection and preoperative imaging is essential. A heart team working collaboratively in a hybrid operating room ensures procedural success. Using this approach, four different manufacturer's transcatheter valves have been used successfully.
CONCLUSIONS
Suprasternal transcatheter aortic valve replacement is a safe and effective addition to the surgeon's armamentarium.
目的
对于股动脉解剖结构不适合的患者，胸骨上窝经导管主动脉瓣置换术为经心尖、直接主动脉和锁骨下途径提供了一种替代方法。
描述
Transit系统（爱尔兰戈尔韦的宙斯盾外科公司）可通过一个小的胸骨上窝切口将经导管主动脉瓣直接置换到升主动脉或无名动脉中。瓣膜导入鞘通过标准荷包缝合插入，这有助于动脉的安全闭合。靠近主动脉瓣便于精确控制。
评估
正确的患者选择和术前影像学检查至关重要。在杂交手术室中协同工作的心脏团队可确保手术成功。使用这种方法，已成功使用了四种不同制造商生产的经导管瓣膜。
结论
胸骨上窝经导管主动脉瓣置换术是外科医生手术器械库中一种安全有效的补充方法。
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