Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
J Card Surg. 2022 Sep;37(9):2920-2922. doi: 10.1111/jocs.16660. Epub 2022 Jun 4.
Aortic complications during cannulation must be managed urgently and often require hypothermic circulatory arrest. We report a unique management strategy to repair an aortic tear without dissection by modifying a Dacron ascending aortic graft with side-arm.
A 32-year-old female patient undergoing reoperative cardiac surgery suffered an unexpected aortic tear during cannulation for cardiopulmonary bypass. The tear was repaired by utilizing a physician-modified ascending aortic graft with side-arm, in which the surrounding skirt of the side-arm was cut from the circumferential graft to patch the defect. The patient was rewarmed with the side-arm serving as arterial inflow for the bypass circuit, and the remainder of the operation proceeded without complication.
This type of aortic repair for aortic tears without dissection can offer the patient the benefit of avoiding multiple aortotomies in a weakened aorta, reducing circulatory arrest time, and re-establishing a central cannulation strategy for cardiopulmonary bypass.
在插管过程中发生的主动脉并发症必须紧急处理，通常需要低温循环停止。我们报告了一种独特的管理策略，通过修改带有侧臂的涤纶升主动脉移植物来修复无夹层主动脉撕裂。
一名 32 岁女性患者在接受心脏手术再次手术后，在体外循环插管过程中意外发生主动脉撕裂。通过使用带有侧臂的医生修改的升主动脉移植物来修复撕裂，其中侧臂的周围裙边从环周移植物上切割下来以修补缺陷。用侧臂作为旁路回路的动脉流入来复温患者，其余手术过程无并发症。
对于无夹层的主动脉撕裂，这种类型的主动脉修复可以为患者提供避免在脆弱的主动脉上多次切开主动脉、减少循环停止时间以及重新建立体外循环的中心插管策略的好处。
