摘要
目的总结Bentall术联合应用三分支支架血管重建全主动脉弓治疗I型主动脉夹层动脉瘤的体外循环管理及方法。方法 2010年9月至2011年11月对3例I型主动脉夹层患者行Bentall加三分支支架血管置入重建全主动脉弓,术中采用深低温停循环及选择性脑灌注的体外循环方法,并积极做好脑、心肌、肾脏、脊髓等脏器的保护措施。结果 3例患者平均体外循环时间(220±25)min,平均心肌缺血时间(91.7±10.4)min,平均选择性脑灌注时间(28±7)min,平均下半身停循环时间(34±8.7)min,平均全身停循环时间(6.3±2.3)min,术后6 h内全部清醒,无神经系统并发症,均痊愈出院。结论应用Bentall手术联合三分支支架血管重建全主动脉弓治疗Ⅰ型夹层,术中采用深低温停循环及选择性脑灌注的体外循环方法以及积极采取重要脏器保护等措施是安全有效的。
bjective To summary the cardiopuimonary bypass experience of DeBakey type Ⅰ aortic dissection underwent extensive primary repair of the thoracic aorta by means of ascending aorta replacement combined with triple - branched stent graft. Methods Between September 2010 and November 2011,3 patients with acute DeBakey type Ⅰ aortic dissection underwent extensive repair of the thoracic aorta by means of ascending aorta replacement combined with triple - branched stent graft. The operations were all performed under general anesthesia, and carried out under deep hypothermia circulatory arrest and selected cerebral perfusion. Results The mean cardiopulmonary bypass time was （220±25） minutes. The mean aortic cross -clamp time was （91.7 ± 10.4） minutes. The mean selective cerebral perfusion time was （28 ± 7 ） minutes. The mean lower - body arrest time was （34 ± 8.7 ） minutes. The mean whole body arrest time was （6.3 ± 2.3 ） minutes. All patients were successfully treated without neurologie complication. All patients were discharged from the hospital. Conclusion The therapy of artificial blood vessel replacement and total arch grafting with triple - branched stent graft is safe. The technique of using selected cerebral perfusion for cerebral protection is safe and effective during deep hypothermie circulatory arrest.
出处
《中国体外循环杂志》
2012年第3期155-157,共3页
Chinese Journal of Extracorporeal Circulation
关键词
Ⅰ型主动脉夹层
全主动脉弓重建
人工血管
支架
体外循环
Type Ⅰ aortic dissection
Total aortic arch reconstruction
Artificial blood vessel
Stent
Cardiopulmonary bypass
