Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospital), Chennai, India.
Asian Cardiovasc Thorac Ann. 2021 Sep;29(7):623-626. doi: 10.1177/0218492320928744. Epub 2020 May 21.
Acute type A aortic dissection remains one of the most challenging condition in cardiothoracic surgery, with a high mortality rate. Various improvements and innovations have happened over the years to better the outcome of this lethal condition. The frozen elephant trunk prosthesis has been developed to negate the long-term complications of acute type A aortic dissection, but at the cost of increased morbidity compared to hemiarch replacement. Although hemiarch and total arch replacement seem have less morbidity than the frozen elephant trunk technique, they do not address the long-term complications of the distal dissected aorta. Few surgeons now suggest hybrid aortic arch repair as a solution for acute type A aortic dissection. The long-term results need to be studied in all procedures before standardizing them. Although multiple strategies are evolving, the short-term goal of acute type A aortic dissection has not changed: to save the patient's life. The surgical strategy has to be tailored according to the patient's condition and the surgeon's experience.
急性 A 型主动脉夹层仍然是心胸外科最具挑战性的疾病之一，死亡率很高。多年来，为了改善这种致命疾病的预后，出现了各种改进和创新。冷冻象鼻假体的发展是为了消除急性 A 型主动脉夹层的长期并发症，但与半弓置换相比，其发病率增加。尽管与冷冻象鼻技术相比，半弓和全弓置换的发病率似乎较低，但它们并不能解决远端夹层主动脉的长期并发症。现在很少有外科医生建议杂交主动脉弓修复作为急性 A 型主动脉夹层的解决方案。在将其标准化之前，需要对所有手术的长期结果进行研究。尽管多种策略正在不断发展，但急性 A 型主动脉夹层的短期目标没有改变：挽救患者的生命。手术策略必须根据患者的病情和外科医生的经验进行调整。
