深低温停循环三分支主动脉弓覆膜支架血管植入治疗急性A型主动脉夹层及主动脉弓严重病变  

Treatment for acute type A aortic dissection and serious aortic arch diseases using implantation of triple-branched aortic arch covered stent under deep hypothermic circulatory arrest

作　　者：王云[1] 杨慧燕[1] 刘旭东[1] 顾继伟[1] 吴继红[1] 渠川铮[1] 

机构地区：[1]宁夏医科大学总医院心脏外科,宁夏银川750004

出　　处：《宁夏医学杂志》2012年第2期103-105,共3页Ningxia Medical Journal

摘　　要：目的应用深低温停循环三分支主动脉弓覆膜支架植入治疗急性A型主动脉夹层及主动脉弓严重病变,并评价其安全性和疗效。方法对6例急性A型主动脉夹层、1例急性B型主动脉夹层累及弓部、1例主动脉弓部瘤破入左侧胸腔患者实施了深低温停循环三分支覆膜支架植入手术,且其中1例行Bentall术,1例行升主动脉置换术。结果 6例患者术后及时清醒,无死亡。体外循环时间(152.8±37.1)min,心肌血运阻断时间(61.4±35.7)min,深低温停循环选择性脑灌注时间(26±10.2)min。其中1例并发急性肾功能衰竭,经血液透析后肾功能恢复正常。随访4～7个月,患者主动脉弓部及分支动脉内支架扩张贴壁满意,相应部位假腔及瘤体消失,远端假腔内血栓填充,无与覆膜支架相关的并发症发生。结论采用深低温停循环三分支主动脉弓覆膜支架植入治疗急性A型主动脉夹层及主动脉弓严重病变,安全、有效、简化。Objective To evaluate the safety and effect of the treatment for acute type A aortic dissection and serious aortic arch diseases by using implantation of triple - branched aortic arch covered stent under deep hypothermic circulatory arrest. Methods From Feb. 2011 to May, 2011, there were six patients, who included three acute type A aortic dissection, one acute type B aortic dissection which involved aortic arch, and one aortic arch aneurysm ruptured into left chest, underwent implantation of triple - branched aortic arch covered stent under deep hypothermic circulatory arrest. Two of them also received either Bentall procedure or aortic arch replacement. Results All patients revived timely after operation, and there was no one died. One developed acute renal failure, but recovered after blood dialysis. The cardiopulmonary bypass time was （ 152.8 ± 37.1 ） rain, the clamp time was （ 61.4 ± 35.7 ） rain, and the time of deep hypothermic circulatory arrest and ante grade selective cerebral perfusion was（26 ± 10.2）rain. During following -up period of 4 to 7months, triple -branched aortic arch covered stent graft expanded well. The corresponding false lumen to the stent graft disappeared, and the distal false lumen was filled with thrombus. There were no complications related to the stent. Condttsion It is safe mad effective to treat the acute type A aortic dissection and serious aortic arch diseases using implantation of triple - branched aortic arch covered stent under deep hypothermie circulatory arrest.

关 键 词：急性A型主动脉夹层 主动脉弓覆膜支架 三分支 深低温停循环 

分 类 号：R654.3[医药卫生—外科学]