Furukawa K, Suda H, Ueno T, Norita H, Naitoh K, Tomita S, Suenaga E, Natsuaki M, Ito T, Ohteki H
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Japan.
Kyobu Geka. 1996 Jul;49(7):548-51.
Recently, extended operation has been recommended for aortic dissection associated with Marfan syndrome. However, the operation for acute type A aortic dissection associated with Marfan syndrome is controversial. Between May 1985 and July 1994, 5 patients associated with acute type A aortic dissection and Marfan syndrome underwent surgical repair. CT examination on all patients, the survivors of the initial operation, revealed a gradually enlarged residual pseudolumen. 2 patients who underwent aortic root reconstruction and ascending aortic replacement for the initial operation eventually had to undergo aortic arch repair. From the results of this study and the improvements of intraoperative cerebral protection, we recommend aortic arch repair with aortic root reconstruction and ascending aortic replacement on initial emergency operation for acute type A aortic dissection associated with Marfan syndrome.
最近，对于与马凡综合征相关的主动脉夹层，推荐进行扩大手术。然而，与马凡综合征相关的急性A型主动脉夹层的手术存在争议。1985年5月至1994年7月，5例与急性A型主动脉夹层和马凡综合征相关的患者接受了手术修复。对所有患者以及初次手术幸存者进行CT检查，发现残余假腔逐渐扩大。2例初次手术进行主动脉根部重建和升主动脉置换的患者最终不得不接受主动脉弓修复。根据本研究结果以及术中脑保护措施的改进，我们建议对与马凡综合征相关的急性A型主动脉夹层在初次急诊手术时进行主动脉弓修复并同时进行主动脉根部重建和升主动脉置换。
