腔内治疗破口位于升主动脉的Stanford A型主动脉夹层

目的初步探讨运用覆膜支架腔内治疗破口位于升主动脉的Stanford A型主动脉夹层的疗效。方法回顾性总结河西学院附属张掖人民医院于2016年12月收治的1例Stanford A型主动脉夹层患者的临床资料。结果该患者在全麻下行主动脉夹层覆膜支架腔内治疗后夹层破口完全消失。手术历时约30 min,出血约5 mL,无夹层逆撕、内漏等并发症发生,且无脑梗塞、心肌梗塞、神经系统相关并发症及其他并发症发生。患者术后恢复良好,无特殊不适,于术后3 d顺利出院。术后2年随访见患者假腔血肿完全吸收,无并发症发生。结论对于破口位于升主动脉的Stanford A型主动脉夹层,通过术前精准评估,对血管条件良好及破口位置适当的升主动脉夹层可行覆膜支架腔内治疗。

Intracavitary isolation in the treatment of Stanford type A aortic dissection

Objective To explore the effect of using a stent graft to treat a Stanford type A aortic dissection with the ascending aorta in the cavity.Method A retrospective review was made of the clinical data of a patient with Stanford type A aortic dissection admitted to Zhangye People’s Hospital Affiliated to Hexi University in December 2016.Results After the patient underwent general anesthesia aortic dissection and stent graft treatment,the dissection fracture completely disappeared.After 2 years of follow-up,the patient’s pseudocavity hematoma was completely absorbed.The operative time was 30 min and the blood loss was about 5 mL.There were no complications such as avulsion of dissection,internal leakage,cerebral infarction,myocardial infarction,nervous system,and other complications occurred.Conclusion For Stanford type A aortic dissection with a tear located in the ascending aorta,intracavitary treatment with coated stent is feasible for ascending aortic dissection with good vascular conditions and tear location through accurate preoperative assessment.