Idhrees Mohammed, Bashir Mohamad, Jakob Heinz
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospital), Chennai, India.
Vascular & Endovascular Surgery, Royal Blackburn Teaching Hospital, Haslingden Road, Blackburn, UK.
Asian Cardiovasc Thorac Ann. 2021 Sep;29(7):619-622. doi: 10.1177/0218492320953338. Epub 2020 Aug 20.
There is abundant of literature emerging to support the use of the frozen elephant trunk prosthesis, but there is still a lack of clear consensus on the sizing of the hybrid prosthesis. There is a general consensus that the stent should not be oversized in acute aortic dissection and chronic aortic dissection. Some surgeons consider that only the true lumen has to be measured while others argue that the entire diameter of the aorta has to be measured, and a few measure the aorta intraoperatively. In regards to thoracic aortic aneurysm, most surgeons oversize the stent-graft by 10% to 20%. A small device may not provide adequate sealing, whereas a larger device may cause new entry points distally. Hence, an appropriate device has to be selected for the optimal outcome.
有大量文献支持使用冰冻象鼻假体,但对于杂交假体的尺寸选择仍缺乏明确的共识。对于急性主动脉夹层和慢性主动脉夹层,普遍的共识是支架不应过大。一些外科医生认为只需要测量真腔,而另一些人则认为必须测量主动脉的整个直径,还有少数人在术中测量主动脉。对于胸主动脉瘤,大多数外科医生将覆膜支架尺寸加大10%至20%。过小的装置可能无法提供足够的密封,而过大的装置可能会在远端导致新的破口。因此,必须选择合适的装置以获得最佳效果。