Nakajima N
First Department of Surgery, Chiba University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1996 Oct;97(10):900-5.
The first prominent report on the surgical treatment for acute aortic dissection was published by DeBakey in 1975. Since then, many various techniques have been applied for the surgery on dissection at ascending aorta and aortic arch. The basic understanding for the surgical treatment are focused to the climination of intimal tear as well as resection and closure of dissecting lumen and restore the blood flow only to the true lumen. The associated complications such as acute dissection AR should also be repaired simultaneously. At the present, the graft replacement of ascending aorta has become first choice of procedure. No matter where the intimal tear is located, the simultaneous replacement of assending aorta and aortic arch has been proposed recently as the most radical approach toward Type A dissection, although this extended approach has to be carefully evaluated in the future.
1975年,德贝基发表了首篇关于急性主动脉夹层外科治疗的重要报告。自那时起,多种不同技术已应用于升主动脉和主动脉弓夹层的手术。外科治疗的基本理念集中于消除内膜撕裂,切除并闭合夹层管腔,仅恢复真腔的血流。诸如急性夹层主动脉瓣反流等相关并发症也应同时修复。目前,升主动脉移植置换术已成为首选术式。无论内膜撕裂位于何处,近来有人提出同时置换升主动脉和主动脉弓是治疗A型夹层最彻底的方法,不过这种扩大术式未来还需仔细评估。