Cabrucci Francesco, Pellegrini Giulio, Bacchi Beatrice, Ferrara Francesco, Balestracci Paolo, Petrone Dario, Bessi Giulia, Codecasa Riccardo
Cardiac Surgery Unit, AOU Careggi Hospital, Università degli studi di Firenze, Florence, Italy.
Cardiac Surgery Unit, AOU Careggi University Hospital, Florence, Italy.
Multimed Man Cardiothorac Surg. 2024 Dec 9;2024. doi: 10.1510/mmcts.2024.099.
Type A aortic dissection is a life-threatening condition that requires immediate surgical intervention. The goal of traditional approaches is to treat the disease promptly, regardless of invasiveness, in order to achieve the quickest surgical outcome. This strategy has been shown to be associated with significant morbidity, extended recovery and postoperative complications. A minimally invasive technique, in particular a mini-sternotomy, even in cases of type A aortic dissection, can be a viable alternative, reducing surgical trauma and postoperative complications. Despite technical challenges, minimally invasive techniques offer benefits, especially for older patients. Beyond the surgical approach, new technologies and devices (like the Ascyrus Medical Dissection Stent) have also emerged, designed to streamline the surgical process while also ensuring effective results. This case highlights the feasibility and safety of minimally invasive techniques in type A aortic dissection in elderly patients, emphasizing the potential of a more conservative yet effective surgical approach.
A型主动脉夹层是一种危及生命的疾病，需要立即进行手术干预。传统方法的目标是迅速治疗该疾病，而不考虑其侵入性，以实现最快的手术结果。已证明这种策略会导致显著的发病率、延长恢复时间和术后并发症。一种微创技术，特别是微创胸骨切开术，即使在A型主动脉夹层病例中，也可能是一种可行的替代方法，可减少手术创伤和术后并发症。尽管存在技术挑战，但微创技术仍有优势，尤其是对老年患者。除了手术方法外，还出现了新技术和设备（如Ascyrus Medical解剖支架），旨在简化手术过程，同时确保有效结果。本病例突出了微创技术在老年A型主动脉夹层患者中的可行性和安全性，强调了采用更保守但有效的手术方法的潜力。
