Antunes M J
Ann Thorac Surg. 1987 Sep;44(3):257-9. doi: 10.1016/s0003-4975(10)62067-x.
This report describes the techniques used in 16 patients for repair of acute traumatic rupture of the aorta. Direct aortic cross-clamping (13 to 27 minutes) was used without additional methods of spinal cord protection. Direct suture was possible in (56%) of the 9 patients with partial rupture of the aorta but in only 1 (14%) of the 7 patients with complete disruption. In the remaining patients, the repair was carried out by interposing Gore-Tex patches (4 patients) or open tubular grafts (6 patients) using a simplified method, which is described. The 2 deaths, 1 intraoperative and 1 postoperative, were unrelated to the technique. There were no additional perioperative complications. Direct aortic cross-clamping and repair by direct suture or open tubular graft, as described, greatly simplify the correction of acute traumatic rupture of the aorta, and their use is strongly recommended.
本报告描述了16例急性创伤性主动脉破裂修复术中所采用的技术。采用直接主动脉交叉钳夹(13至27分钟),未使用其他脊髓保护方法。9例主动脉部分破裂患者中有5例(56%)可行直接缝合,但7例完全断裂患者中仅1例(14%)可行。其余患者采用简化方法,通过置入戈尔泰克斯补片(4例)或开放管状移植物(6例)进行修复,文中对此方法进行了描述。2例死亡,1例术中死亡,1例术后死亡,均与手术技术无关。围手术期无其他并发症。如所述,直接主动脉交叉钳夹以及直接缝合或开放管状移植物修复极大地简化了急性创伤性主动脉破裂的矫正,强烈建议采用这些方法。