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A型主动脉夹层初次手术后并发症的影像学监测

Imaging surveillance for complications after primary surgery for type A aortic dissection.

作者信息

Heuts Samuel, Schalla Simon, Ramaekers Mitch J F G, Bidar Elham, Mihl Casper, Wildberger Joachim E, Adriaans Bouke P

机构信息

Department of Cardiothoracic Surgery, Maastricht Universitair Medisch Centrum+, Maastricht, Limburg, The Netherlands

Department of Cardiology, Maastricht University Medical Centre+, Maastricht, Limburg, The Netherlands.

出版信息

Heart. 2022 Dec 22;109(2):96-101. doi: 10.1136/heartjnl-2022-320881.

Abstract

Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires emergency surgery to avert fatal outcome. Conventional surgical procedures comprise excision of the entry tear and replacement of the proximal aorta with a synthetic vascular graft. In patients with DeBakey type I dissection, this approach leaves a chronically dissected distal aorta, putting them at risk for progressive dilatation, dissection propagation and aortic rupture. Therefore, ATAAD survivors should undergo serial imaging for evaluation of the aortic valve, proximal and distal anastomoses, and the aortic segments beyond the distal anastomosis. The current narrative review aims to describe potential complications in the early and late phases after ATAAD surgery, with focus on their specific imaging findings.

摘要

急性A型主动脉夹层(ATAAD)是一种危及生命的疾病,需要紧急手术以避免致命后果。传统的外科手术包括切除入口撕裂处并用人工血管移植物替换近端主动脉。对于DeBakey I型夹层患者,这种方法会使远端主动脉长期处于夹层状态,使其面临进行性扩张、夹层扩展和主动脉破裂的风险。因此,ATAAD幸存者应接受系列影像学检查,以评估主动脉瓣、近端和远端吻合口以及远端吻合口以外的主动脉节段。本叙述性综述旨在描述ATAAD手术后早期和晚期的潜在并发症,重点关注其特定的影像学表现。

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