摘要
目的 总结 1996年 1月至 2 0 0 2年 8月收治的 34例 A型主动脉夹层动脉瘤的外科治疗经验。 方法 应用 Bentall手术 19例 ,升主动脉人工血管置换术 7例 ,升主动脉人工血管置换加主动脉瓣成形术 (Trusler's法 )5例 ,分别行升主动脉人工血管置换及主动脉瓣置换术 (Wheat术 ) 2例 ,升主动脉、主动脉弓人工血管置换术 1例。结果 手术死亡 6例 ,死亡率 17.6 %。其中慢性主动脉夹层动脉瘤死亡 3例 ,急性夹层动脉瘤死亡 3例。随访 2 0例 ,随访率 71.4 %。随访时间 2～ 4 6个月 ,平均 2 4 .7个月 ,1例术后 3个月猝死 (原因不明 ) ,1例术后 6个月死于心内膜炎。18例存活患者情况良好。 结论 应根据夹层动脉瘤的部位及范围采用不同的手术方式 ,保留主动脉瓣的升主动脉人工血管置换术治疗该病效果较好 ,准确可靠的吻合技术、保留瘤壁的完整性 ,将使手术更为安全。
ObjectiveTo review the experience of surgical treatment of 34 patients with type A aortic dissecting aneurysm from January 1996 to August 2002.MethodsThe operative procedures included Bentall procedure (n=19), graft replacement of ascending aorta (n=7), graft replacement of ascending aorta and aortic valveplasty (n=5), separated replacement of the aortic valve and ascending aorta (n=2), graft replacement of ascending aorta and aortic arch(n=1).ResultsThere were 6 operative deaths with a mortality of 17.6%, and 20 patients were followed-up. The rate of follow-up was 71.4% and the duration of follow-up was 2-46 months (mean, 24.7 months). One patient died from sudden death 3 months after operation. One patient died from endocarditis 6 months after operation. Other 18 patients live uneventfully.ConclusionsDifferent operative methods should be selected according to the different condition of aortic dissecting aneurysm. Meticulous suture technique and intact aneurysm wall may make operation safer.
出处
《中国胸心血管外科临床杂志》
CAS
2002年第4期251-253,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
