Cukingnan R A, Fee H J, Carey J S
J Thorac Cardiovasc Surg. 1978 Feb;75(2):227-31.
Utilizing a heparinized tridodecylmethylammonium chloride (TDMAC) shunt makes it possible to treat various surgical diseases of the descending thoracic aorta without cardiopulmonary bypass. Since the initial report by Gott and associates on the use of the heparinized shunt, few subsequent clinical trials have appeared in the literature. Six patients with Type III dissecting thoracic aneurysm, acquired and congenital coarctation of the aorta, saccular arteriosclerotic aneurysm, and transection of the descending thoracic aorta were operated upon by means of this technique. Only one patient had more than 500 ml. of chest tube drainage in the first 8 hours postoperatively. There were no instances of paraplegia, renal failure, or death. This technique is also recommended for repair of innominate artery aneurysms, endarterectomy of the innominate or subclavian artery, arch aneurysm, penetrating injuries of the thoracic aorta, and proximal abdominal aneurysms. Surgical indications, operative management, and postoperative follow-up are discussed.
使用肝素化的三癸基甲基氯化铵（TDMAC）分流术可以在不进行体外循环的情况下治疗降主动脉的各种外科疾病。自戈特及其同事首次报道使用肝素化分流术以来，文献中很少有后续的临床试验出现。六例III型胸主动脉夹层动脉瘤、后天性和先天性主动脉缩窄、囊状动脉硬化性动脉瘤以及降主动脉横断的患者接受了该技术手术。仅1例患者术后8小时内胸腔引流超过500毫升。无截瘫、肾衰竭或死亡病例。该技术也推荐用于无名动脉动脉瘤修复、无名动脉或锁骨下动脉内膜切除术、主动脉弓动脉瘤、胸主动脉穿透伤以及近端腹主动脉瘤。文中讨论了手术指征、手术管理及术后随访情况。
