应用近端加长覆膜支架及“改良”无名动脉插管行全弓置换术治疗Stanford A型主动脉夹层  

Total Arch Replacement with Proximal Lengthening Grafted Stent and Modified Innominate Artery Cannula for Stanford A Aortic Dissection

作　　者：于洋[1] 谷天祥[1] 师恩祎[1] 王春[1] 喻磊[1] 于鹏[1] 刘波[1] 

机构地区：[1]中国医科大学附属第一医院心脏外科,沈阳110001

出　　处：《中国胸心血管外科临床杂志》2016年第5期476-479,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评价应用近端加长覆膜支架及"改良"无名动脉插管行全弓置换治疗Stanford A型夹层的近期临床效果。方法回顾性分析2012年12月至2015年1月我院收治的21例Stanford A型主动脉夹层患者的临床资料,其中男16例、女5例,平均年龄57岁。21例患者均应用近端加长覆膜支架和我中心自行研制的"改良"无名动脉插管行全弓置换术。结果 21例患者平均手术时间为(187.0±31.1)min,体外循环时间(116.0±32.0)min,主动脉阻断时间(87.0±23.0)min,选择性脑灌注时间(23.0±3.9)min,术后应用呼吸机时间为(19.0±6.0)h,术后ICU停留时间(3.0±0.9)d。所有患者术后恢复良好,无死亡病例,无严重并发症发生。结论应用近端加长覆膜支架及"改良"无名动脉插管行全弓置换术治疗Stanford A型夹层疗效确切、简单安全,近期随访结果满意。Objective To evaluate the short-term result of proximal lengthening grafted stent and modified innominate artery cannula for Stanford A aortic dissection.Method We retrospectively analyzed the clinical data of 21 patients with Stanford A aortic dissection in our hospital between December 2012 and January 2015.There were 16 males and 5 females at a mean age of 57 years.All 21 patients underwent total arch replacement with proximal lengthening grafted stent and modified innominate artery cannula invented by our center.Result The mean operation time of 21 patients was 187.0±31.1 minutes,the mean cardiopulmonary bypass time was 116.0±32.0 minutes,the mean aortic block time was 87.0±23.0 minutes,the mean selective cerebral perfusion（SCP） time was 23.0±3.9 minutes,the mean breathing machanical ventilation time was 19.0±6.0 hours,and the mean intensive care unit stay time was 3.0±0.9 days.All patients had a good recovery after surgery.There was no death or severe complications.Conclusion The technique of total arch replacement with proximal lengthening grafted stent and modified innominate artery cannula for Stanford A aortic dissection is effective,easy,and safe.The short-term result is satisfying.

关 键 词：主动脉夹层 无名动脉 插管 简化手术 

分 类 号：R654.3[医药卫生—外科学]