右心房分流术在主动脉根部手术中的应用 |
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引用本文: | 木拉提·米吉提,李立勇,兰智新,于鹏,李永军,谷冰,何志杰,贾志英,迪力夏提. 右心房分流术在主动脉根部手术中的应用[J]. 中华胸心血管外科杂志, 2008, 24(5) |
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作者姓名: | 木拉提·米吉提 李立勇 兰智新 于鹏 李永军 谷冰 何志杰 贾志英 迪力夏提 |
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作者单位: | 解放军四七四医院心外科,乌鲁木齐,830013 |
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摘 要: | 目的 总结右心房分流术在主动脉根部手术中的应用体会.方法 1995年11月至2008年3月,69例主动脉根部手术中,26例主动脉根部出血的病例行右心房分流术,其中马方综合征致主动脉夹层7例,主动脉根部瘤19例.单纯升主动脉破口 6例,多发性破口3例,夹层均可见不同程度的积血及血栓.采用全麻、低温、体外循环下手术,股动脉右心房插管低温体外循环20例,右锁骨下动脉、右心房插管低温体外循环加选择性顺行脑灌注深低温停循环3例,右侧股动脉、右心房插管低温体外循环加深低温停循环2例,股静脉、右锁骨下动脉插管加深低温停循环1例.均采用进口涂层螺纹带瓣管道.21例行主动脉Bentall手术,5例行升主动脉加部分弓置换者采用深低温停循环.12例心脏复跳后主动脉根部出血行右心房分流术,14例为常规预防性行右心房--右心耳分流术.结果 26例均治愈出院,随访5个月~11年无早期及远期出血,无行右心房分流术所致的各种并发症.心功能(NYHA)Ⅰ~Ⅱ级,均正常工作及生活.结论 右心房分流术在主动脉手术中能有效预防主动脉根部出血,使主动脉根部的手术安全性明显提高,且能有效防止主动脉根部出血所致的各种并发症,提高手术功率.
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关 键 词: | 主动脉疾病 心脏外科手术 |
Right-atrium distributary in aortic-root's operations |
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Abstract: | Objecive To summariz the experience of applying right-atrium distributary in aortic root's operation. Methods From Nov. 1995 to March 2008, sixty-nine patients with aortic root disease received surgical treatment. Right-atrium distributary was applied in 26 patients who had aortic incision bleeding near the end of operation. Results In the follow-up of 5 months to 11 years, no severe complications happened. All of their's heart function were (NYHA) Ⅰ-Ⅱgrade. Conclusion The reasonable application of right-atrium distributaries is safe and credible for patients with aortic root's disease in operation. |
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Keywords: | Aortic diseases Cardiac surgical procedures |
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