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微创心脏手术期间的急性主动脉夹层：一例病例报告。

Acute aortic dissection during minimally invasive cardiac surgery: a case report.

作者信息

Kumamoto Taisuke

机构信息

Department of Anesthesiology, Saiseikai Kumamoto Hospital, 5-3-1 Minami-Ku, Chikami Kumamoto, 861-4193, Japan.

出版信息

JA Clin Rep. 2025 Jan 31;11(1):6. doi: 10.1186/s40981-025-00771-2.

DOI:10.1186/s40981-025-00771-2
PMID:39888557
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11785884/
Abstract

BACKGROUND

Management of acute aortic dissection (AAD) caused by retrograde perfusion through the femoral artery during minimally invasive cardiac surgery (MICS) remains controversial. We present a case of AAD occurring during the late cardiopulmonary bypass (CPB) phase, which was successfully managed by vascular graft replacement, without altering the blood supply route.

CASE PRESENTATION

A 63-year-old man was scheduled for totally endoscopic aortic valve replacement. CPB was initiated through the right femoral artery and venous cannulation. Approximately 120 min after the initiation of CPB, mean arterial pressure and bilateral cerebral regional oxygen saturation temporarily decreased. Transesophageal echocardiography revealed type A AAD. Cerebral perfusion was preserved, allowing us to proceed to deep hypothermic circulatory arrest and successfully perform ascending aortic replacement without altering the blood supply route.

CONCLUSIONS

In MICS, continuous monitoring is crucial as AAD can occur at any point during CPB, and early detection enables successful outcomes.

摘要

背景

在微创心脏手术（MICS）期间，经股动脉逆行灌注引起的急性主动脉夹层（AAD）的处理仍存在争议。我们报告一例在体外循环（CPB）后期发生的AAD病例，通过血管移植置换成功处理，且未改变血供途径。

病例介绍

一名63岁男性计划行全内镜主动脉瓣置换术。通过右股动脉和静脉插管开始CPB。CPB开始约120分钟后，平均动脉压和双侧脑局部氧饱和度暂时下降。经食管超声心动图显示为A型AAD。脑灌注得以维持，使我们能够进行深低温停循环，并在不改变血供途径的情况下成功进行升主动脉置换。

结论

在MICS中，持续监测至关重要，因为AAD可在CPB期间的任何时间发生，早期检测可实现成功的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/00c5e6f2d90c/40981_2025_771_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/7a44329f4b90/40981_2025_771_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/12b9809d28d3/40981_2025_771_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/00c5e6f2d90c/40981_2025_771_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/7a44329f4b90/40981_2025_771_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/12b9809d28d3/40981_2025_771_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20df/11785884/00c5e6f2d90c/40981_2025_771_Fig3_HTML.jpg

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本文引用的文献

1
A case of TEVAR for acute aortic dissection after MICS AVR and retroperitoneal tumor resection.1例在微创主动脉瓣置换术和腹膜后肿瘤切除术后行胸主动脉腔内修复术治疗急性主动脉夹层的病例。
J Surg Case Rep. 2021 Dec 23;2021(12):rjab559. doi: 10.1093/jscr/rjab559. eCollection 2021 Dec.
2
Iatrogenic Acute Aortic Dissection in the Era of Minimally Invasive Cardiac Surgery - Experience of a Center and Review of Literature.微创心脏外科时代的医源性急性主动脉夹层：中心经验及文献回顾。
Braz J Cardiovasc Surg. 2021 Oct 17;36(5):691-699. doi: 10.21470/1678-9741-2020-0561.
3
Iatrogenic Aortic Dissection Associated With Cardiac Surgery: A Narrative Review.
与心脏手术相关的医源性主动脉夹层：一篇叙述性综述。
J Cardiothorac Vasc Anesth. 2021 Oct;35(10):3050-3066. doi: 10.1053/j.jvca.2020.07.084. Epub 2020 Aug 7.
4
Numerical simulation of blood flow in femoral perfusion: comparison between side-armed femoral artery perfusion and direct femoral artery perfusion.股动脉灌注中血流的数值模拟：侧支股动脉灌注与直接股动脉灌注的比较。
J Artif Organs. 2016 Dec;19(4):336-342. doi: 10.1007/s10047-016-0911-z. Epub 2016 Jun 2.
5
Cannulation Strategies and Pitfalls in Minimally Invasive Cardiac Surgery.微创心脏手术中的插管策略与陷阱
Methodist Debakey Cardiovasc J. 2016 Jan-Mar;12(1):10-3. doi: 10.14797/mdcj-12-1-10.
6
A highly fatal intraoperative urgency--aortic dissection complicating heart surgery.一种高度致命的术中紧急情况——主动脉夹层合并心脏手术。
Kardiol Pol. 2009 Aug;67(8):858-63.
7
Intraoperative iatrogenic type A aortic dissection and perioperative outcome.术中医源性A型主动脉夹层及围手术期结局。
Interact Cardiovasc Thorac Surg. 2006 Feb;5(1):11-4. doi: 10.1510/icvts.2005.114900. Epub 2005 Oct 28.