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Debakey Ⅰ型夹层动脉瘤升主动脉替换术后二期腔内支架治疗降主动脉病变
引用本文:张永,郝嘉,王学峰,李福平,肖颖彬.Debakey Ⅰ型夹层动脉瘤升主动脉替换术后二期腔内支架治疗降主动脉病变[J].第三军医大学学报,2012,34(4):347-349.
作者姓名:张永  郝嘉  王学峰  李福平  肖颖彬
作者单位:第三军医大学新桥医院全军心血管外科中心,重庆,400037
摘    要:目的 总结急性Debakey Ⅰ型夹层急诊行升主动脉替换术后,择期行经股动脉腔内隔绝降主动脉的治疗体会.方法 2008年6月至2011年2月,我院心血管外科对5例急性Debakey Ⅰ型夹层患者急诊行升主动脉替换术后,择期行经股动脉腔内隔绝降主动脉.术后定期复查CT血管造影,了解升主动脉及降主动脉内支架情况.结果 5例患者手术成功,无严重并发症,体外循环时间232(208 ~266)min.升主动脉阻断时间155( 113 ~ 152) min,所有患者顺利出院.术后1个月及3个月门诊随访复查CT血管造影示人工血管通畅,支架无移位,并压缩远端假腔.结论 对于急性Debakey Ⅰ型夹层患者,急诊行升主动脉替换术,择期行经股动脉腔内隔绝降主动脉为一种安全有效的手术方式.

关 键 词:心脏外科手术  Debakey  Ⅰ型夹层  人工血管  主动脉支架

Application of stent-graft placement for descending aorta after ascending aorta replacement for acute Debakey type Ⅰ dissection
Zhang Yong , Hao Jia , Wang Xuefeng , Li Fuping , Xiao Yingbin.Application of stent-graft placement for descending aorta after ascending aorta replacement for acute Debakey type Ⅰ dissection[J].Acta Academiae Medicinae Militaris Tertiae,2012,34(4):347-349.
Authors:Zhang Yong  Hao Jia  Wang Xuefeng  Li Fuping  Xiao Yingbin
Institution:(Cardiovascular Surgery Center,Xinqiao Hospital,Third Military Medical University,Chongqing,400037,China)
Abstract:Objective To summarize an approach for treatment of acute Debakey type Ⅰ dissection with emergency ascending aorta replacement and then selective stent-graft placement of descending aorta via arteria femoralis.Methods A total of 5 cases of acute Debakey type Ⅰ dissection with emergency ascending aorta replacement and then selective stent-graft placement of the descending aorta via arteria femoralis in our department were included from Jun 2008 to Feb 2011.Computed tomography angiography(CTA)was regularly carried out to monitor the ascending aorta and stent of descending aorta.Results The treatments of the 5 cases were successful with no severe complication,with extracorporeal circulation for 208 to 266 min(average 232 min),and aorta cross-clamp for 113 to 152 min(average 155 min),and the recovery was uneventful.Follow-ups were carried out in the first month and third month after operation.With all the cases,CTA indicated an unobstructed blood vessel prosthesis,non-displacement stand,and compressed false lumen of distal aorta.Conclusion As for patients with acute Debakey type Ⅰ dissection,it is a safe and effective application for emergency ascending aorta replacement and then selective stent-graft placement of descending aorta via arteria femoralis.
Keywords:cardiac surgical procedures  Debakey type Ⅰ dissection  blood vessel prosthesis  stent-graft
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