StanfordA型主动脉夹层主动脉弓替换加支架象鼻术后F1DCT评估及意义

目的通过MDCT随访评估主动脉弓替换加支架象鼻术治疗StaflfOrdA型主动脉夹层的效果及其术后并发症。方法回顾性分析98例患者共167次主动脉MDCT术后随访检查。结果98例患者出现心包积液40例，胸腔积液69例，肺不张55例，升主动脉人工血管吻合口漏l8例，主动脉弓部远端覆膜支架I型内漏10例，其中支架近端内漏7例、远端内漏3例，纵膈气肿6例，支架以远假腔血栓形成82例，死亡1例。升主动脉人工血管吻合口漏与支架I型内漏发生率间有统计学意义联系。结论主动脉弓替换加支架象鼻术能有效治疗stanfOrdh型主动脉夹层：MDCT可作为主动脉弓替换加支架象鼻术后随访的重要方法。

Evaluation of Stanford Type A Aortic Dissec- tion After Total Arch Replacement Combined with Stented Elephant Trunk Implantation by MDCT

Obiective To evaluate the role of total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection by MDCT. Methods 98 patients, 167 MDCT results were retrospectively analyzed. Results After total arch replace- ment combined with stented elephant trunk implantation, pericardial effusion（n=40）, pleural effusion（n=69）, atelectasis（n=55）, stomal leak of ascending aorta（n=18）, type l endoleak of stent（n= 10）,including endoleak of proximal stent（n=7） and endoleak ot distal stent（n=3）, mediastinal emphasema（n=6）, thrombosis of residual false lumen（n=82）, death（n=1） were observed. Significant relationships between incidences of stomal leak and endoleak of stent were found. Conclusion Total arch replacement combined with stented elephant trunk implantation is effective for Stanford type A aortic dissection. MDCT is an important method to evaluate postoperative changes of total arch replacement combined with stented elephant trunk implantation.