心脏不停跳小切口支架象鼻置入手术治疗B型主动脉夹层的可行性分析  

Feasibility analysis on stented elephant trunk procedure with beating heart for Stanford B type aortic dissection through single upperhemisternotomy approach

作　　者：姜辉 刘宇 杨忠路 葛玉光 王璐 周恩涛 王辉山 JIANG Hui;LIU Yu;YANG Zhong-lu;GE Yu-guang;WANG Lu;ZHOU En-tao;WANG Hui-shan(Department of Cardiovascular Surgery,General hospital of Shenyang Military Command,Shenyang 110016.China)

机构地区：[1]北部战区总医院心血管外科,辽宁省沈阳市110016

出　　处：《中国心血管病研究》2022年第5期432-435,共4页Chinese Journal of Cardiovascular Research

基　　金：辽宁省自然科学基金(2020-KF-12-01,2020JH2/10300161);辽宁省“兴辽英才计划”项目(XLYC2007053)。

摘　　要：目的探讨胸骨上段小切口心脏不停跳行支架象鼻置入手术在B型主动脉夹层中应用的可行性与安全性。方法回顾性分析2019年3月至2021年8月共14例确诊为Stanford B型主动脉夹层的患者,其中男性13例、女性1例,年龄53(41,65)岁。采用心脏不停跳支架象鼻置入术治疗并收集临床资料。结果全组患者均在单一胸骨上段小切口完成手术,无围术期死亡;体外循环时间107(94,145)min,选择性心脏灌注时间26(23,32)min,下半身停循环及单侧选择性脑灌注时间23(19,26)min,呼吸机辅助23(18,33)h,ICU停留3(2,3)d。结论心脏不停跳胸骨上段小切口型支架象鼻置入手术治疗B型主动脉夹层是安全可行的。Objective To evaluate the feasibility and safety of stented elephant trunk procedure with beating heart for Stanford B type aortic dissection through upperhemisternotomy approach.Methods A total of14 patients(13 male and 1 female)with Stanford B type aortic dissection were retrospective for this study,who were 53(41,65)years old.Stented elephant trunk procedure were carried out through upperhemisternotomy approach with beating heart and the perioperative characteristics were collected.Results All patients were finished Stented elephant trunk procedure through single upperhemisternotomy approach without perioperative death.The time of cardiopulmonary bypass,selective heart perfusion and circulation arrest were respectively 107(94,145)min,26(23,32)min and 23(19,26)min.Postoperative time of ventilation and ICU stay were respectively 23(18,33)h and 3(2,3)d.Conclusions Stented elephant trunk procedure with beating heart through upperhemisternotomy approach was safe and feasible for Stanford B type aortic dissection.

关 键 词：不停跳心脏手术 胸骨上段切口 主动脉夹层 

分 类 号：R543.1[医药卫生—心血管疾病]