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急性B型主动脉夹层合并迷走右锁骨下动脉及双侧颈总动脉干的杂交修复术。

Hybrid repair of acute type B dissection with aberrant right subclavian artery and bicarotid trunk.

作者信息

Downey Peter S, Thors Axel, Johnson Phillip, Gupta Kamal, Wallisch William J, Almoghrabi Omar, Muehlebach Gregory F, Zorn George L

机构信息

Department of Cardiovascular and Thoracic Surgery, University of Kansas Health System, Kansas City, KS.

Division of Vascular Surgery, Department of Surgery, University of Kansas Health System, Kansas City, KS.

出版信息

J Vasc Surg Cases Innov Tech. 2022 Mar 22;8(2):214-217. doi: 10.1016/j.jvscit.2022.03.003. eCollection 2022 Jun.

DOI:10.1016/j.jvscit.2022.03.003
PMID:35493339
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9048060/
Abstract

Patients with type B aortic dissection (TBAD) often present as an emergency. Operative repair of TBAD can be indicated for selected patients in the setting of hemodynamic instability or rupture. Thoracic endovascular aortic repair of TBAD has achieved significant popularity. Variant aortic arch anatomy can present a significant clinical challenge in patients with an inadequate proximal landing zone for thoracic endovascular aortic repair. A three-stage, hybrid aortic arch debranching and endovascular repair of a ruptured TBAD in a patient with a bicarotid trunk and an aberrant right subclavian artery was successfully performed using a unique technical approach.

摘要

B型主动脉夹层（TBAD）患者常以急症形式出现。对于血流动力学不稳定或破裂情况下的部分患者，可考虑对TBAD进行手术修复。TBAD的胸主动脉腔内修复术已颇受欢迎。在胸主动脉腔内修复术近端锚定区不足的患者中，主动脉弓解剖变异可能带来重大临床挑战。采用独特的技术方法，成功地为一名具有双侧颈总动脉干和迷走右锁骨下动脉的患者实施了破裂TBAD的三阶段杂交主动脉弓去分支和腔内修复术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/089b/9048060/dd8cf32f6166/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/089b/9048060/483ccca1bccc/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/089b/9048060/dd8cf32f6166/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/089b/9048060/483ccca1bccc/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/089b/9048060/dd8cf32f6166/gr2.jpg

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Classic hybrid arch debranching (type I hybrid arch repair) without circulatory arrest.无循环阻断的经典杂交主动脉弓去分支术（I型杂交主动脉弓修复术）。
Ann Cardiothorac Surg. 2018 May;7(3):443-450. doi: 10.21037/acs.2018.05.06.
3
National trends in admissions, repair, and mortality for thoracic aortic aneurysm and type B dissection in the National Inpatient Sample.
国家住院患者样本中胸主动脉瘤和 B 型夹层的入院、修复和死亡率的全国趋势。
J Vasc Surg. 2018 Jun;67(6):1649-1658. doi: 10.1016/j.jvs.2017.09.050. Epub 2018 Mar 2.
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Hybrid Techniques for Aortic Arch Aneurysm Repair.主动脉弓动脉瘤修复的杂交技术
Semin Cardiothorac Vasc Anesth. 2016 Dec;20(4):327-332. doi: 10.1177/1089253216659701. Epub 2016 Jul 13.
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Management of acute type B aortic dissection; ADSORB trial.急性 B 型主动脉夹层的治疗；ADSORB 试验。
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