Cardiac Surgery Department, Lancisi Cardiovascular Center, Ospedali Riuniti, Politechnic University of Marche, Ancona, Italy.
Vascular Surgery Department, Ospedali Riuniti, Ancona, Italy.
Ann Thorac Surg. 2021 Aug;112(2):e143-e145. doi: 10.1016/j.athoracsur.2020.12.092. Epub 2021 Mar 2.
Aortic arch repair with frozen elephant trunk is increasingly offered to patients with extensive thoracic aortic disease. Given the magnitude of such a procedure, reported postoperative mortality and morbidity have to be considered adequate but not negligible. To further improve postoperative outcomes we developed a hybrid approach allowing frozen elephant trunk to be performed without hypothermia and circulatory arrest. After an initial experience in patients with chronic aneurysms, we successfully adopted the same approach in a patient with type 1 acute aortic dissection. Transfemoral stent-graft deployment, balloon clamping, and an always antegrade aortic perfusion are key elements of the approach presented here.
主动脉弓修复采用冷冻象鼻技术越来越多地应用于广泛的胸主动脉疾病患者。鉴于手术的规模，报告的术后死亡率和发病率必须被认为是适当的，但并非可以忽略不计。为了进一步改善术后结果，我们开发了一种杂交方法，允许在不使用低温和循环停止的情况下进行冷冻象鼻手术。在慢性动脉瘤患者中获得初步经验后，我们成功地将相同的方法应用于 1 型急性主动脉夹层患者。经股动脉支架移植、球囊夹闭和始终顺行的主动脉灌注是本研究方法的关键要素。
