分期杂交手术治疗胸腹主动脉夹层_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

李树春 , 周庆 , 金珉 ,  王东进

南京大学医学院附属鼓楼医院心胸外科江苏省大血管疾病诊疗中心（南京 210008）;

Corresponding author：

王东进, Email: gldjw@163.com

Keywords：

胸腹主动脉夹层; 腔内隔绝术; 腹主动脉去分支化; 杂交手术

DOI：

10.7507/1007-4848.202002052

Video：

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目的总结腹主动脉去分支化手术联合主动脉腔内隔绝术治疗胸腹主动脉夹层的经验。方法自 2018 年 1 月至 2019 年 6 月，南京鼓楼医院采用腹主动脉去分支化手术联合主动脉腔内隔绝术治疗胸腹主动脉夹层 12 例，男 10 例、女 2 例，年龄 36～63（50±9）岁。结果随访 6～24 个月，全组无死亡，1 例术后左下肢单瘫，1 例出现肾功能不全。随访期间 1 例患者术后 1 个月出现主动脉支架近端逆撕，行全主动脉弓置换术后痊愈。2 例患者出现腹腔干动脉近端内漏，予以弹簧圈栓塞后痊愈，其余患者 CT 血管造影（CTA）检查未见吻合口造影剂渗漏及人工血管扭曲、闭塞。结论腹主动脉去分支化手术联合主动脉腔内隔绝术治疗胸腹主动脉夹层可取得良好近期疗效，中远期疗效仍有待进一步观察随访。

Citation： 李树春, 周庆, 金珉, 王东进. 分期杂交手术治疗胸腹主动脉夹层. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(9): 1099-1102. doi: 10.7507/1007-4848.202002052 Copy

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1. Riambau V, Böckler D, Brunkwall J, <italic>et al</italic>. Editor's choice—management of descending thoracic aorta diseases: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg, 2017, 53(1): 4.
2. Kazui T, Yamashita K, Washiyama N, <italic>et al</italic>. Impact of an aggressive surgical approach on surgical outcome in type A aortic dissection. Ann Thorac Surg, 2002, 74: S1844-S1847.
3. Halstead JC, Meier M, Etz C, <italic>et al</italic>. The fate of the distal aorta after repair of acute type A aortic dissection. J Thorac Cardiovasc Surg, 2007, 133: 127-135.
4. Zierer A, Voeller RK, Hill KE, <italic>et al</italic>. Aortic enlargement and late reoperation after repair of acute type A aortic dissection. Ann Thorac Surg, 2007, 84: 479-487.
5. Geirsson A, Bavaria JE, Swarr D, <italic>et al</italic>. Fate of the residual distal and proximal aorta after acute type A dissection repair using a contemporary surgical reconstruction algorithm. Ann Thorac Surg, 2007, 84: 1955-1964.
6. Resch TA, Delle M, Falkenberg M, <italic>et al</italic>. Remodeling of the thoracic aorta after stent grafting of type B dissection: a Swedish multicenter study. J Cardiovasc Surg (Torino), 2006, 47(5): 503-508.
7. Lombardi JV, Gleason TG, Panneton JM, <italic>et al</italic>. STABLE Ⅱ clinical trial on endovascular treatment of acute, complicated type B aortic dissection with a composite device design. J Vasc Surg, 2020, 71(4): 1077-1087.e2.
8. Quiñones-Baldrich WJ, Panetta TF, Vescera CL, <italic>et al</italic>. Repair of typeⅣthoracoabdominal aneurysm with a combined endovascular and surgical approach. J Vasc Surg, 1999, 30(3): 555-560.
9. Bakoyiannis C, Kalles V, Economopoulos K, <italic>et al</italic>. Hybrid procedures in the treatment of thoracoabdominal aortic aneurysms: a systematic review. J Endovasc Ther, 2009, 16: 443-450.
10. Canaud L, Karthikesalingam A, Jackson D, <italic>et al</italic>. Clinical outcomes of single versus staged hybrid repair for thoracoabdominal aortic aneurysm. J Vasc Surg, 2013, 58: 1192-1200.
11. Yamaguchi D, Jordan WD Jr. Hybrid thoracoabdominal aortic aneurysm repair: current perspectives. Semin Vasc Surg, 2012, 25: 203-207.
12. Bockler D, Kotelis D, Geisbusch P, <italic>et al</italic>. Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections—a single center experience in 28 patients. J Vasc Surg, 2008, 47: 724-732.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

分期杂交手术治疗胸腹主动脉夹层

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