摘要
目的 总结Stanford B型主动脉夹层胸主动脉腔内修复术(TEVAR)后再发Stanford A型主动脉夹层的手术治疗经验。方法 收集2015年1月至2022年12月于新疆医科大学第一附属医院进行手术治疗的10例Stanford B型主动脉夹层TEVAR术后再发Stanford A型主动脉夹层患者的临床资料。所有患者出院后均通过门诊或电话的方式进行随访,随访时间为18~102个月。记录患者的治疗情况、随访结果。结果 所有患者均顺利完成手术,围手术期无死亡。5例患者术后发生了主要并发症,包括低心排出量综合征1例,脑梗死2例,肾功能不全1例,切口感染1例。2例患者于术后1、13个月死于急性脑出血,1例患者于术后4年发生脑梗死。1例患者升主动脉人工血管置换术后1年发现胸腹主动脉瘤样扩张,患者拒绝手术,选择长期密切随访。结论 Stanford B型主动脉夹层TEVER术后再发Stanford A型主动脉夹层外科手术治疗可取得良好疗效。
Objective To sum up the experience with surgical treatment of retrograde Standford type A aortic dissection following thoracic endovascular aortic repair(TEVAR)of Standford type B aortic dissection.Method The clinical data of 10 patients with retrograde Standford type A aortic dissection after TEVAR for Standford type B aortic dissection who underwent surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2022 were collected.All patients were followed up through outpatient or telephone follow-up after discharge,with a follow-up period of 18-102 months.The patients'treatment status and follow-up results were recorded.Result Surgeries were conducted successfully in all patients,and no mortality occurred during the perioperative period.There were 5 patients experienced major postoperative complications,including one case of low cardiac out-put syndrome,two cases of cerebral infarction,one case of renal dysfunction,and one case of incision infection.Two patients died of acute cerebral hemorrhage at 1 and 13 months after the surgery,and one patients had developed cerebral infarction at 4 years after the surgery.One patient was found to have thoracoabdominal aortic aneurysm like dilation one year after ascending aortic artificial vessel replacement surgery,the patient refused the surgery and chose long-term close follow-up. Conclusion The surgical treatment can provide satisfactory results in patients with retrograde Standford type A aortic dissection after TEVER of Standford type B aortic dissection.
作者
俞国军
伊力哈木江·克尤木
刘正
艾克热木·吐尔逊
朱涛
霍强
张为民
Yu Guojun;Ilhamjan·Kayumu;Liu Zheng;Akram·Tursun;Zhu Tao;Huo Qiang;Zhang Weimin(Department of Cardiac Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang,China)
出处
《血管与腔内血管外科杂志》
2024年第2期161-164,共4页
Journal of Vascular and Endovascular Surgery
基金
新疆维吾尔自治区自然科学基金(2020D01C242)。
关键词
主动脉夹层
再发夹层
胸主动脉腔内修复术
手术
并发症
aortic dissection
retrograde dissection
thoracic endovascular aortic repair
surgery
complication
