支架“象鼻”术治疗DeBakey Ⅰ型主动脉夹层动脉瘤  

The experience of stent ＂elephant trunk＂ procedure in treatment of DeBakey Ⅰaortic dissection

作　　者：王霖[1] 蒋海河[1] 陈胜喜[1] 罗凡砚[1] 雷凯波[1] 

机构地区：[1]中南大学附属湘雅医院心胸外科,长沙410008

出　　处：《中华实验外科杂志》2010年第4期528-529,共2页Chinese Journal of Experimental Surgery

摘　　要：目的探讨支架“象鼻”手术治疗DeBakeyⅠ型主动脉夹层动脉瘤（AD）的方法和效果。方法12例DeBakeyⅠ型AD患者，平均年龄48．1岁。采用深低温停循环（DHCA），右腋动脉顺行灌注（SCP）脑保护，实施支架“象鼻”手术（即升主动脉和全弓置换及降主动脉腔内支架植入）。结果术后死亡1例，手术死亡率8．3％。术中体外循环时间（163．2±17．7）min，停循环时间（41．6±12．3）min。随访3．6个月，无死亡病例。结论支架“象鼻”手术简单，停循环时间短，治疗DeBakeyⅠ型夹层主动脉瘤安全、有效。Objective To investigate the procedures and outcomes of stent ＂elephant trunk＂ technique in the treatment of DeBakey Ⅰaortic dissection. Methods Twelve patients （mean 48. 1 years old） with DeBakey Ⅰaortic dissection were included in our study. During deep hypothermic circulatory arrest （ DHCA）, selected antegrade cerebral perfusion （SCP） was used to protect the brain. All patients received stent ＂elephant trunk＂ procedure （ascending aorta and arch replacement combined with transluminal stent graft of the descending aorta）. Results One patient died after operation （8.3%）. The average cardiopulmonary bypass time was （ 163. 2 ± 17.7 ） min. The average circulatory arrest time was （41.6 ± 12. 3 ） min. Survival patients were followed up for 3 to 6 months and no subsequent death occurred during the fellow-up period. Conclusion The stent ＂elephant trunk＂ procedure is a simple method with short circulatory arrest time. It seems to be effective and safe for DeBakey Ⅰaortic dissection.

关 键 词：主动脉夹层动脉瘤 支架“象鼻”术 

分 类 号：R654.2[医药卫生—外科学]