Fakim Djalal, Qin Chaoyi, Chu Michael W A
Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada.
1Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada 2Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Multimed Man Cardiothorac Surg. 2023 Dec 7;2023. doi: 10.1510/mmcts.2023.092.
The extent of repair in patients with acute type A aortic dissection is often determined by factors such as entry tear location, aortic anatomy, malperfusion and team expertise. The hybrid arch frozen elephant trunk, which has become an established technique to extend the distal acute type A aortic dissection repair, is particularly useful in malperfusion; however, it remains technically challenging and is associated with increased duration of circulatory arrest and risks of spinal cord ischaemia. Proximal dissection flap extension often determines repairability versus replacement of the aortic root. We present a case report highlighting the proximal and distal extent of repair in a patient with a known ascending aortic aneurysm presenting with an acute type A aortic dissection, with malperfusion, undergoing a successful bio-Bentall procedure and hybrid arch frozen elephant trunk repair.
急性A型主动脉夹层患者的修复范围通常由诸如破口位置、主动脉解剖结构、灌注不良和团队专业技能等因素决定。杂交主动脉弓冰冻象鼻术已成为一种用于扩展远端急性A型主动脉夹层修复的成熟技术，在灌注不良的情况下尤其有用；然而，它在技术上仍然具有挑战性，并且与循环阻断时间延长和脊髓缺血风险相关。近端夹层瓣延伸通常决定了主动脉根部是可修复还是需置换。我们报告一例病例，突出显示了一名已知升主动脉瘤并伴有急性A型主动脉夹层、灌注不良的患者，在成功接受生物Bentall手术和杂交主动脉弓冰冻象鼻术修复时的近端和远端修复范围。
