Bhandari Apoorva, Chu Michael W A, Duncan Audra
Division of Vascular Surgery, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada.
Division of Cardiac Surgery, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada.
J Vasc Surg Cases Innov Tech. 2024 Dec 3;11(2):101701. doi: 10.1016/j.jvscit.2024.101701. eCollection 2025 Apr.
Despite advancements in surgical techniques and critical care, managing complications of type A and B aortic dissections remains challenging. Common morbidities include paraplegia, renal failure, stroke, and intestinal ischemia. Risks are especially high in extensive repairs, such as Crawford extent II thoracoabdominal aortic aneurysms, and in older patients or those with heart failure, poor pulmonary function, or renal disease. To mitigate these risks, less invasive techniques like total endovascular and hybrid approaches have been developed. We present a case of a 69-year-old female with an 8.5-cm type II thoracoabdominal aortic aneurysm with chronic dissection, successfully treated with a staged hybrid repair.
尽管手术技术和重症监护有所进步,但处理A型和B型主动脉夹层的并发症仍然具有挑战性。常见的并发症包括截瘫、肾衰竭、中风和肠缺血。在进行广泛修复时,如克劳福德II型胸腹主动脉瘤修复,以及老年患者或患有心力衰竭、肺功能差或肾病的患者中,风险尤其高。为了降低这些风险,已经开发了诸如全腔内修复和杂交手术等侵入性较小的技术。我们报告一例69岁女性患者,患有8.5厘米的II型胸腹主动脉瘤并伴有慢性夹层,通过分期杂交修复成功治疗。