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复杂主动脉弓动脉瘤的双转位与医生改良腔内修复术

Double Transposition and Physician-Modified Endografting for Complex Arch Aneurysm.

作者信息

Nissen Alexander P, Jordan William D, Leshnower Bradley G

机构信息

Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia.

Department of Surgery, Augusta University Health, Augusta, Georgia.

出版信息

Ann Thorac Surg Short Rep. 2024 Jun 15;2(3):327-330. doi: 10.1016/j.atssr.2024.05.020. eCollection 2024 Sep.

DOI:10.1016/j.atssr.2024.05.020
PMID:39790396
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11708643/
Abstract

Hybrid repair of complex aortic arch disease typically requires aortic debranching to create a proximal landing zone for completion arch endografting. Despite advances in endograft technology, physician-modified endografting may be required to customize a prosthesis for challenging anatomy. We present a case of a complex distal arch aneurysm after a prior coarctation repair with a pediatric interposition graft several decades earlier, treated with hybrid repair by double transposition for arch debranching and physician-modified arch endografting for complete aneurysm exclusion.

摘要

复杂主动脉弓疾病的杂交修复通常需要进行主动脉分支血管离断术，以创建一个近端锚定区来完成弓部腔内修复术。尽管腔内修复技术有所进步，但对于具有挑战性的解剖结构，可能仍需要医生对腔内修复进行调整，以定制合适的假体。我们报告了一例复杂的远端弓部动脉瘤病例，该患者数十年前曾接受小儿血管移植术治疗主动脉缩窄，此次采用双转位杂交修复术进行弓部血管离断，并通过医生调整的弓部腔内修复术完全排除动脉瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/9c03c39a6e1c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/4b30380f4e60/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/7a3381096ad9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/9c03c39a6e1c/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/4b30380f4e60/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/7a3381096ad9/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea90/11708643/9c03c39a6e1c/gr3.jpg

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本文引用的文献

1
Parallel grafts and physician modified endografts for endovascular repair of the aortic arch.用于主动脉弓血管腔内修复的平行移植物和医生改良型腔内移植物
Ann Cardiothorac Surg. 2022 Jan;11(1):16-25. doi: 10.21037/acs-2021-taes-171.
2
Application of deep hypothermic circulatory arrest in open left chest aortic aneurysm repair.深低温停循环在开放性左胸主动脉瘤修复术中的应用。
J Thorac Cardiovasc Surg. 2023 Apr;165(4):1275-1280. doi: 10.1016/j.jtcvs.2021.03.080. Epub 2021 Mar 31.
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Contemporary Management of Aortic Arch Aneurysm.主动脉弓动脉瘤的当代治疗方法。
Semin Thorac Cardiovasc Surg. 2019;31(4):697-702. doi: 10.1053/j.semtcvs.2019.03.011. Epub 2019 Apr 11.
4
Double transposition and single branched TEVAR for total arch replacement in chronic dissection.双转位和单分支胸主动脉腔内修复术用于慢性主动脉夹层的全主动脉弓置换术
Ann Cardiothorac Surg. 2018 May;7(3):434-436. doi: 10.21037/acs.2018.05.02.
5
Surgical repair of descending thoracic and thoracoabdominal aortic aneurysm involving the distal arch: open proximal anastomosis under deep hypothermia versus arch clamping technique.涉及远端主动脉弓的降胸段和胸腹主动脉瘤的外科修复：深低温下开放近端吻合术与主动脉弓阻断技术的比较
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Hybrid approaches in the treatment of aortic arch aneurysms: postoperative and midterm outcomes.主动脉弓动脉瘤治疗的杂交方法：术后和中期结果。
J Thorac Cardiovasc Surg. 2013 Mar;145(3 Suppl):S85-90. doi: 10.1016/j.jtcvs.2012.11.044. Epub 2012 Dec 20.