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[主动脉瓣再植入术联合全主动脉弓置换术治疗A型主动脉夹层]

[Aortic valve reimplantation combined with total arch replacement in type A aortic dissection].

作者信息

Boldyrev S Yu, Bezdenezhnykh O S, Abidzakh S B, Sapunov V A, Barbukhatti K O

机构信息

Research Institute - Ochapovsky Regional Clinical Hospital No. 1, Krasnodar, Russia.

Kuban State Medical University, Krasnodar, Russia.

出版信息

Khirurgiia (Mosk). 2025(1):80-85. doi: 10.17116/hirurgia202501180.

Abstract

We present simultaneous aortic valve reimplantation, replacement of aortic arch, right common carotid artery and proximal parts of the right subclavian and left common carotid arteries in a patient with type I aortic dissection. Involvement of supra-aortic arteries is the main predictor of cerebral malperfusion and mortality in acute aortic dissection. Optimal surgical intervention in such patients is still unclear. Moreover, patients with acute ascending aortic dissection rarely undergo valve-sparing surgery, since such interventions require much time and prolong myocardial ischemia.

摘要

我们报告了1例I型主动脉夹层患者同时进行主动脉瓣再植入、主动脉弓置换、右颈总动脉以及右锁骨下动脉近端和左颈总动脉置换的病例。主动脉弓上动脉受累是急性主动脉夹层患者脑灌注不良和死亡的主要预测因素。对此类患者的最佳手术干预措施仍不明确。此外,急性升主动脉夹层患者很少接受保留瓣膜手术,因为此类手术需要很长时间且会延长心肌缺血时间。

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