老年 Stanford A型主動脈夾層外科治療_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

何杰 ^1,3 ,  范小平 ¹ , 黃勁松 ¹ , 彭繼海 ² , 張鳴生 ² , 蔡詩豪 ^1,3 , 許文柳 ³

1. ;
2. ;
3. ;

Corresponding?author：

范小平, Email: fukui-hanson@hotmail.com

Keywords：

主動脈夾層; 老年; 外科治療

DOI：

10.7507/1007-4848.201803074

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的總結老年 Stanford A 型主動脈夾層（Stanford type A aortic dissection，AAD）外科治療經驗，探討手術方式和要點，以提高外科治療療效。方法 2014 年 12 月至 2017 年 12 月對 23 例老年 Stanford A 型主動脈夾層患者（年齡≥70 歲）行手術治療，均在全身麻醉、低溫停循環及雙側順行性腦灌注下進行。其中男 18 例、女 5 例，年齡（73.6±4.1）歲。結果全組體外循環時間（207.5±38.3）min，主動脈阻斷時間（148.1±35.7）min，停循環時間（9.4±5.1）min，手術時間（7.2±3.6）h，術后體外膜肺氧合（extracorporeal memberane oxygenation，ECMO）支持 2 例，透析 4 例，2 例（8.9%）住院期死亡。全組患者出院前及術后 3 個月復查主動脈全程 CT 提示：覆膜支架及其分支血管通暢無狹窄，支架位置正常，主動脈弓及降主動脈假腔完全血栓化 19 例，部分血栓化 3 例。結論對于老年 Stanford A 型主動脈夾層患者，外科治療仍是首選。減少或避免低溫尤其是深低溫停循環對患者的負面影響，最大限度縮短全身重要臟器缺血時間及總體手術時間是手術成功的關鍵。

Citation： 何杰, 范小平, 黃勁松, 彭繼海, 張鳴生, 蔡詩豪, 許文柳. 老年 Stanford A型主動脈夾層外科治療. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(5): 514-518. doi: 10.7507/1007-4848.201803074 Copy

1.	Pape LA, Awais M, Woznicki EM, et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol, 2015, 66(4): 350-358.
2.	Dai XF, Chen LW, Chen DZ, et al. Analysis of surgical treatment for Standford type A aortic dissection. Zhonghua Wai Ke Za Zhi, 2008, 46(11): 823-825.
3.	Minakawa M, Fukuda I, Yamauchi S, et al. Early and long-term outcome of total arch replacement using selective cerebral perfusion. Ann Thorac Surg, 2010, 90(1): 72-77.
4.	Stevens LM, Madsen JC, Isselbacher EM, et al. Surgical management and long-term outcomes for acute ascending aortic dissection. J Thorac Cardiovasc Surg, 2009, 138(6): 1349-1357.
5.	Trimarchi S, Eagle KA, Nienaber CA, et al. Role of age in acute type A aortic dissection outcome: report from the International Registry of Acute Aortic Dissection (IRAD). J Thorac Cardiovasc Surg, 2010, 140(4): 784-789.
6.	Rylski B, Suedkamp M, Beyersdorf F, et al. Outcome after surgery for acute aortic dissection type A in patients over 70 years: data analysis from the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardiothorac Surg, 2011, 40(2): 435-440.
7.	Ma WG, Zheng J, Dong SB, et al. Sun's procedure of total arch replacement using a tetrafurcated graft with stented elephant trunk implantation: analysis of early outcome in 398 patients with acute type A aortic dissection. Ann Cardiothorac Surg, 2013, 2(5): 621-628.
8.	Zhang Q, Ma X, Zhang W, et al. Surgical repair and reconstruction of aortic arch in de Bakey type Ⅰ aortic dissection: recent advances and single-center experience in the application of branched stent graft. J Cardiothorac Surg, 2017, 12(1): 86.

1. Pape LA, Awais M, Woznicki EM, et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol, 2015, 66(4): 350-358.
2. Dai XF, Chen LW, Chen DZ, et al. Analysis of surgical treatment for Standford type A aortic dissection. Zhonghua Wai Ke Za Zhi, 2008, 46(11): 823-825.
3. Minakawa M, Fukuda I, Yamauchi S, et al. Early and long-term outcome of total arch replacement using selective cerebral perfusion. Ann Thorac Surg, 2010, 90(1): 72-77.
4. Stevens LM, Madsen JC, Isselbacher EM, et al. Surgical management and long-term outcomes for acute ascending aortic dissection. J Thorac Cardiovasc Surg, 2009, 138(6): 1349-1357.
5. Trimarchi S, Eagle KA, Nienaber CA, et al. Role of age in acute type A aortic dissection outcome: report from the International Registry of Acute Aortic Dissection (IRAD). J Thorac Cardiovasc Surg, 2010, 140(4): 784-789.
6. Rylski B, Suedkamp M, Beyersdorf F, et al. Outcome after surgery for acute aortic dissection type A in patients over 70 years: data analysis from the German Registry for Acute Aortic Dissection Type A (GERAADA). Eur J Cardiothorac Surg, 2011, 40(2): 435-440.
7. Ma WG, Zheng J, Dong SB, et al. Sun's procedure of total arch replacement using a tetrafurcated graft with stented elephant trunk implantation: analysis of early outcome in 398 patients with acute type A aortic dissection. Ann Cardiothorac Surg, 2013, 2(5): 621-628.
8. Zhang Q, Ma X, Zhang W, et al. Surgical repair and reconstruction of aortic arch in de Bakey type Ⅰ aortic dissection: recent advances and single-center experience in the application of branched stent graft. J Cardiothorac Surg, 2017, 12(1): 86.

Previous Article
肝癌合并門靜脈癌栓的診治進展
Next Article
終末期肝病/肝移植術后合并冠狀動脈粥樣硬化性心臟病患者不停跳冠狀動脈旁路移植術三例

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

老年 Stanford A型主動脈夾層外科治療

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content