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急性A型主动脉夹层的冰冻象鼻技术:手术技巧与体外循环管理

Frozen elephant trunk in acute type A aortic dissection: surgical techniques and the extracorporeal circuit management.

作者信息

Idhrees Mohammed, Ibrahim Mohammed, Krishnaswami Murali, Jacob Aju, Velayudhan Bashi

机构信息

Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Vadapalani, Chennai, 600 026 India.

出版信息

Indian J Thorac Cardiovasc Surg. 2021 May;37(3):303-306. doi: 10.1007/s12055-020-01038-4. Epub 2020 Sep 5.

Abstract

Acute type A aortic dissection (ATAAD) is a challenging clinical condition with immediate and late complications. Frozen elephant trunk (FET) has been offered as a solution for it promises to address the late complications-false lumen thrombosis and aortic remodelling. Here, we describe the implantation of the FET in ATAAD with the surgical technique and extracorporeal circuit management. A 54-year-old male presented with retrograde type A aortic dissection with an entry point distal to the left subclavian artery. He underwent FET using Thoraflex™ hybrid vascular prosthesis (Vascutek, Inchinnan, Scotland). Three-month follow-up showed a complete obliteration of the false lumen in the descending thoracic aorta. FET in ATAAD is a valid option in the hands of experienced surgeons, while patient selection still remains the key in this surgery.

摘要

急性A型主动脉夹层(ATAAD)是一种具有即时和晚期并发症的具有挑战性的临床病症。由于冷冻象鼻技术(FET)有望解决晚期并发症——假腔血栓形成和主动脉重塑,因此被视为一种解决方案。在此,我们描述了采用手术技术和体外循环管理在ATAAD中植入FET的情况。一名54岁男性因逆行性A型主动脉夹层就诊,其破口位于左锁骨下动脉远端。他接受了使用Thoraflex™混合血管假体(Vascutek,因钦南,苏格兰)的FET手术。三个月的随访显示胸降主动脉假腔完全闭塞。在经验丰富的外科医生手中,ATAAD中的FET是一种有效的选择,而患者选择仍然是该手术的关键。

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Frozen elephant trunk in acute type A aortic dissections: frontiers and challenges.急性A型主动脉夹层中的冰冻象鼻技术:前沿与挑战
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本文引用的文献

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Hybrid aortic arch repair: 10-year experience from India.杂交主动脉弓修复术:来自印度的10年经验。
Indian J Thorac Cardiovasc Surg. 2019 Jun;35(Suppl 2):156-163. doi: 10.1007/s12055-018-0689-0. Epub 2018 Aug 16.
4
Frozen elephant trunk surgery in acute aortic dissection.急性主动脉夹层的主动脉弓部“象鼻”手术
J Thorac Cardiovasc Surg. 2015 Feb;149(2 Suppl):S105-9. doi: 10.1016/j.jtcvs.2014.07.098. Epub 2014 Aug 10.

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