外科理论与实践2017，Vol.22Issue(4)：310-315,6.DOI:10.16139/j.1007-9610.2017.04.009
逆向烟囱技术和升主动脉包裹术治疗急性A型主动脉夹层
Reverse chimney technique and ascending aorta wrapping for acute type A aortic dissection
摘要
Abstract
Object To summarize thoracic endovascular aortic repair ( TEVAR ) using reverse chimney technique and ascending aorta wrapping for acute type A aortic dissection . Methods From February 2013 to April 2017 , 17 patients with severe complications in whom the conventional surgical procedure was judged to be highly risky were subjected to TEVAR with reverse chimney technique in a periscope configuration to supply all supra-arch branches . If the ascending aorta dilated to more than 40 mm , sternotomy was performed to wrap the ascending aorta and to adapt the aortic stent grafts . Results All patients were treated successfully . TEVAR with reverse chimney technique was used in 16 cases and ascending aorta wrapping in 9 cases and supra-arch bypass in 7 cases . The perioperative death rate was 12%(2/17) in the high risky patients. None of the patients experienced thrombosis in the stent grafts, cere-brovascular accident, or peripheral artery embolism. All patients had normal invasive arterial pressure postoperative and normal blood pressure during follow-up . Conclusions The hybrid procedure that include TEVAR with reverse chimney technique , ascending aorta wrapping and supra-arch bypass without long time of extracorporeal circulation could achieve a higher survival rate in treating the patients with acute type A dissection .关键词
急性A型主动脉夹层/逆向烟囱技术/潜望镜技术/杂交手术/升主动脉包裹术Key words
Acute type A aortic dissection/Reverse chimney technique/Periscope technique/Hybrid proce-dure/Ascending aorta wrapping分类
医药卫生引用本文复制引用
高峰..逆向烟囱技术和升主动脉包裹术治疗急性A型主动脉夹层[J].外科理论与实践,2017,22(4):310-315,6.基金项目
海南社会发展项目基金(SF201420) （SF201420）
