分期雜交手術治療胸腹主動脈夾層_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

李樹春 , 周慶 , 金珉 ,  王東進

南京大學醫學院附屬鼓樓醫院心胸外科江蘇省大血管疾病診療中心（南京 ?210008）;

Corresponding?author：

王東進, Email: gldjw@163.com

Keywords：

胸腹主動脈夾層; 腔內隔絕術; 腹主動脈去分支化; 雜交手術

DOI：

10.7507/1007-4848.202002052

Video：

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目的總結腹主動脈去分支化手術聯合主動脈腔內隔絕術治療胸腹主動脈夾層的經驗。方法自 2018 年 1 月至 2019 年 6 月，南京鼓樓醫院采用腹主動脈去分支化手術聯合主動脈腔內隔絕術治療胸腹主動脈夾層 12 例，男 10 例、女 2 例，年齡 36～63（50±9）歲。結果隨訪 6～24 個月，全組無死亡，1 例術后左下肢單癱，1 例出現腎功能不全。隨訪期間 1 例患者術后 1 個月出現主動脈支架近端逆撕，行全主動脈弓置換術后痊愈。2 例患者出現腹腔干動脈近端內漏，予以彈簧圈栓塞后痊愈，其余患者 CT 血管造影（CTA）檢查未見吻合口造影劑滲漏及人工血管扭曲、閉塞。結論腹主動脈去分支化手術聯合主動脈腔內隔絕術治療胸腹主動脈夾層可取得良好近期療效，中遠期療效仍有待進一步觀察隨訪。

Citation： 李樹春, 周慶, 金珉, 王東進. 分期雜交手術治療胸腹主動脈夾層. 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, B?ckler 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. Qui?ones-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

分期雜交手術治療胸腹主動脈夾層

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