García-Rinaldi R, Carballido J, Mojica J, Soltero E R, Curcic S, Barceló J, Porro R
Division of Cardiovascular Surgery, Pavía Heart Institute, San Juan, Puerto Rico 00910.
Ann Thorac Surg. 1998 May;65(5):1255-9. doi: 10.1016/s0003-4975(98)00139-8.
The adventitial inversion technique obliterates the false lumen and converts a dissected aorta into a conduit with tough adventitia on the inside and outside. Dacron grafts can be anastomosed to the aorta with fine sutures, which hold without tears.
From August 1995 to March 1997, we treated 6 patients with acute dissecting aneurysms. Three aneurysms were type I (A) involving the entire aorta, two type II (A) involving the ascending aorta, and one type III (B) involving the thoracoabdominal aorta. Circulatory arrest was used in 3 patients, 1 with type I aneurysm (A), 1 type II (A), and 1 type III (B).
All Dacron-aorta anastomoses held sutures well and did not bleed intraoperatively or postoperatively. One patient (type II [A]) died of intraoperative low cardiac output. In patients with type I (A) aneurysms, the false lumen was obliterated, but 1 patient required resection of a 6-cm abdominal aortic aneurysm.
The adventitial inversion technique is a safe technique for the treatment of acute dissecting aneurysms, which facilitates operation and solves the problem of intraoperative or postoperative bleeding due to tissue friability.
外膜翻转技术可闭塞假腔，将夹层主动脉转变为内外均有坚韧外膜的管道。涤纶人工血管可用细缝线与主动脉吻合，缝线牢固不易撕裂。
1995年8月至1997年3月，我们治疗了6例急性夹层动脉瘤患者。其中3例为I（A）型，累及整个主动脉；2例为II（A）型，累及升主动脉；1例为III（B）型，累及胸腹主动脉。3例患者采用了循环阻断，其中1例I（A）型动脉瘤、1例II（A）型和1例III（B）型。
所有涤纶人工血管与主动脉的吻合缝线固定良好，术中及术后均未出血。1例患者（II [A]型）死于术中低心排血量。I（A）型动脉瘤患者的假腔被闭塞，但1例患者需要切除6cm的腹主动脉瘤。
外膜翻转技术是治疗急性夹层动脉瘤的一种安全技术，便于手术操作，解决了因组织脆弱导致的术中或术后出血问题。
