简化主动脉弓手术：开放2区主动脉弓并完成单分支胸段血管腔内主动脉修复术。
Simplifying aortic arch surgery: open zone 2 arch with single branched thoracic endovascular aortic repair completion.
作者信息
Desai Nimesh D, Hoedt Ashley, Wang Grace, Szeto Wilson Y, Vallabhajosyula Prasthanth, Reinke Mary, Bavaria Joseph E
机构信息
Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
Ann Cardiothorac Surg. 2018 May;7(3):351-356. doi: 10.21037/acs.2018.05.08.
Abstract
BACKGROUND
Distal aortic complications from acute DeBakey I dissection repair are an important source of late morbidity and mortality. We present an early experience of using a novel single-branched thoracic aortic endograft in conjunction with open techniques to treat acute DeBakey I aortic dissection.
METHODS
The patients in this series include five hyperacute dissections managed with a combined zone 2 partial arch replacement and placement of a zone 2 single subclavian branch endograft.
RESULTS
There were no perioperative mortalities, strokes, or spinal cord ischemia in any patients at either stage of the procedure. At follow-up imaging, no patients had anterograde flow into the false lumen. All patients experienced false lumen thrombosis in the stented portion of the aorta.
CONCLUSIONS
This combination of open repair techniques and the use of a novel branched endograft resulted in excellent early outcomes in this pioneer series. Further investigation of these techniques in a prospective fashion is warranted.
摘要
背景
急性DeBakey I型主动脉夹层修复术后的远端主动脉并发症是晚期发病和死亡的重要来源。我们展示了使用新型单分支胸主动脉内移植物结合开放技术治疗急性DeBakey I型主动脉夹层的早期经验。
方法
本系列患者包括5例超急性夹层，采用联合2区部分弓置换和2区单锁骨下分支内移植物置入术进行治疗。
结果
在手术的任何阶段，所有患者均未发生围手术期死亡、中风或脊髓缺血。在随访影像学检查中，没有患者出现顺行血流进入假腔。所有患者的主动脉支架置入部分均出现假腔血栓形成。
结论
在这个先驱系列中，开放修复技术与新型分支内移植物的联合使用产生了优异的早期结果。有必要对这些技术进行前瞻性进一步研究。
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