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急性A型主动脉夹层修复术后天然主动脉的转归:一项磁共振成像研究

Fate of the native aorta after repair of acute type A dissection: a magnetic resonance imaging study.

作者信息

Moore N R, Parry A J, Trottman-Dickenson B, Pillai R, Westaby S

机构信息

Oxford Heart Centre, Oxford Radcliffe Hospital, Headington, UK.

出版信息

Heart. 1996 Jan;75(1):62-6. doi: 10.1136/hrt.75.1.62.

Abstract

OBJECTIVE

To determine late patency of the aortic false lumen and propensity for aneurysm formation after repair of type A dissection.

DESIGN

Retrospective follow up study.

SETTING

Regional cardiac surgical unit.

PATIENTS

28 patients after repair of type A dissection.

METHODS

Magnetic resonance imaging (MRI) was performed between 6 weeks and 12 months after operation.

RESULTS

A patent distal false lumen with demonstrable blood flow was found in 22 patients (78%). Only six patients had complete obliteration of the false lumen by thrombus. The conduct of operation did not influence this. Nine patients (32%) showed aneurysmal dilatation of the false lumen and three had a repeat operation.

CONCLUSIONS

So-called "successful repair" of aortic dissection does not obliterate the distal false lumen. MRI is a safe and effective radiological procedure for determining patency and dilatation in the false lumen. Patients with type A dissection with blood flow in the false lumen should be studied every 6 months to look for aneurysmal dilatation.

摘要

目的

确定A型主动脉夹层修复术后主动脉假腔的晚期通畅情况以及动脉瘤形成倾向。

设计

回顾性随访研究。

地点

地区心脏外科中心。

患者

28例A型主动脉夹层修复术后患者。

方法

术后6周~12个月行磁共振成像(MRI)检查。

结果

22例患者(78%)发现远端假腔通畅且有明显血流。仅6例患者假腔内血栓形成致假腔完全闭塞。手术方式对此无影响。9例患者(32%)出现假腔动脉瘤样扩张,3例接受再次手术。

结论

所谓主动脉夹层“成功修复”并未消除远端假腔。MRI是确定假腔通畅情况及扩张的安全有效的影像学检查方法。假腔内有血流的A型主动脉夹层患者应每6个月检查一次,以寻找动脉瘤样扩张。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb26/484224/4d0be51aa785/heart00013-0077-a.jpg

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