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主动脉右弓右降合并Stanford B型主动脉夹层的外科治疗
引用本文:王晓龙,张宏家,刘愚勇,郑铁,贡鸣,李海洋,刘欧,孙立忠. 主动脉右弓右降合并Stanford B型主动脉夹层的外科治疗[J]. 心肺血管病杂志, 2012, 31(5): 503-505
作者姓名:王晓龙  张宏家  刘愚勇  郑铁  贡鸣  李海洋  刘欧  孙立忠
作者单位:北京 首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科5病房,100029
基金项目:国家自然科学基金(编号:81170283,30872536);新世纪优秀人才(编号:NCEL-11-0899);北京市自然科学基金(编号:7112041);北京市教育委员会科技发展计划面上项目(编号:SQKM201210025017)
摘    要:目的:总结主动脉右弓右降合并Stanford B型主动脉夹层的外科治疗经验。方法:3例右位主动脉弓、右位降主动脉、迷走左锁骨下动脉(迷走左锁骨下动脉型)合并Stanford B型主动脉夹层的患者经胸部右后外切口行胸降主动脉置换术、迷走左锁骨下动脉缝扎术。结果:3例患者均痊愈出院,住院天数7~10 d,无左上肢缺血症状及神经系统并发症。结论:主动脉右弓右降合并Stanford B型主动脉夹层患者行胸降主动脉置换术方法可行,临床疗效满意,术中判断后行迷走左锁骨下动脉缝扎术,可简化手术方式,但应避免术后左上肢缺血坏死。

关 键 词:右位主动脉弓  右位降主动脉  迷走左锁骨下动脉  主动脉夹层  Stanford B

The surgical treatment of type B aortic dissection involving the right aortic arch
WANG Xiaolong , ZHANG Hongjia , LIU Yuyong , ZHENG Tie , GONG Ming , LI Haiyang , LIU Ou , SUN Lizhong. The surgical treatment of type B aortic dissection involving the right aortic arch[J]. Journal of Cardiovascular and Pulmonary Diseases, 2012, 31(5): 503-505
Authors:WANG Xiaolong    ZHANG Hongjia    LIU Yuyong    ZHENG Tie    GONG Ming    LI Haiyang    LIU Ou    SUN Lizhong
Affiliation:.Department of Cardiovascular Surgery,Capital Medical University affiliated Beijing Anzhen Hospital,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China.
Abstract:Objective:To summarize experience in surgical treatment of Stanford B aortic dissection involving right-sided aortic arch with right –sided descending aorta.Methods: Data of 3 cases of Stanford B aortic dissection involving right-sided aortic arch with right-sided descending aorta and aberrant left subclavian artery were reviewed.Descending thoracic aorta graft replacement and aberrant left subclavian artery transfixion were performed via right posterolateral thoracotomy.Results: All 3 patients survived the operation.Hospitalization days were 3 to 7.They had no symptoms of left upper limb ischemia or nervous system complications.Conclusion: The application of descending thoracic aorta graft replacement in treatment of Stanford B aortic dissection involving right-sided aortic arch with right-sided descending aorta and aberrant left subclavian artery is feasible and could acquire satisfied clinical effect.We could simplify operational procedure with the use of aberrant left subclavian artery transfixion after the evaluation in the operation.It is essential to avoid left upper limb necorsis.
Keywords:Right-sided aortic arch  Right –sided descending aorta  Aberrant left subclavian artery  Aortic dissection  Stanford B
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