急性A型主动脉夹层的主动脉弓部重建

doi:10.3969/j.issn.1006-7795.2015.03.002

摘要/Abstract

摘要：

主动脉夹层是一种凶险的心血管外科急症,其中急性A型主动脉夹层致死率最高,及时的诊断和治疗可显著降低病死率.随着主动脉外科的快速发展,主动脉夹层的治疗方法越来越多样化,除了传统的外科开放手术外,还出现了分支支架血管植入、杂交手术、主动脉腔内修复等技术.但是治疗方法越多,越能说明该疾病缺乏统一、简便、安全、有效的适合所有患者的手术方式.由于主动脉弓在解剖、功能及病理改变上的复杂性,人们对于弓部重建的最适策略一直争议不断.本文将目前开展的急性A型主动脉夹层弓部重建方法进行综述,并做简析.

关键词: 主动脉夹层, 弓部重建, 外科手术, 杂交手术, 腔内修复

Abstract:

Acute type A aortic dissection involving the aortic arch remains an inherently lethal medical condition ever since it is known to us. Prompt diagnosis and proper treatment is urgently needed and supposed to significantly lower the mortality rate. Although open surgical repair is undoubtedly the mainstream technique now, high rate of postoperative mortality and morbidity has always been a formidable challenge. Along with the rapid development of the aortic surgery and cognition of the disease, a variety of approaches have been invented or introduced, mostly aiming at simplifying procedure, minimizing surgical trauma and improving prognoses at the same time. Apart from the conventional surgical operation, recently emerged Sun's procedure, open branched stent graft placement, hybrid procedure, and even the endovascular repair have been taken into consideration. However, the more choices we have, the more we come to realize that ideal techniques with the characteristics of stability, convenience, riskless, effectiveness and wide applicability remain to be pursued. Because of the complexity of aortic arch in aspects of anatomy, function and pathological changes, the appropriate approach for patients with type A dissection involving the aortic arch remains controversial. This article provides current information about strategies of aortic arch reconstruction used for acute type A aortic dissection by reviewing related publications as well as brief discussions.

Key words: aortic dissection, arch reconstruction, surgical operation, hybrid procedure, endovascular repair

中图分类号:

孙立忠, 戎天华. 急性A型主动脉夹层的主动脉弓部重建[J]. 首都医科大学学报, 2015, 36(3): 338-344.

Sun Lizhong, Rong Tianhua. Aortic arch reconstruction for acute type A aortic dissection[J]. Journal of Capital Medical University, 2015, 36(3): 338-344.

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