升主动脉-颈内动脉自体静脉转流治疗累及左颈总动脉起始部的巨大真性动脉瘤

The Investigation of Radical Operation for Giant Carotid Aneurysm Involving the Root of Left Common Carotid Artery Using Ascending Aorta and Internal Carotid Artery Bypass through Venous Autograft

目的探讨累及左颈总动脉起始部的巨大真性动脉瘤的手术方法。方法回顾性总结1997年2月至2004年6月间3例该病患者的临床资料,均行手术治疗:胸部正中切口显出前纵隔,切开心包及其返折,显露心脏及其大血管,联合颈部切口显出动脉瘤全貌,升主动脉-颈内动脉自体静脉转流后,于主动脉弓上切除动脉瘤。结果3例均于术后7d治愈出院,分别随访8月、5年、7年无动脉瘤复发。结论利用自体静脉行升主动脉-颈内动脉移植技术,经胸部正中切口根治累及左颈总动脉起始部的巨大动脉瘤,具有显露清晰、操作方便、无须切开胸腔、创伤小、恢复快的优点,是一种较好的手术方案。

Objective To investigate the operative method for giant carotid aneurysm involving the root of left common carotid artery. Methods 3 cases of giant carotid aneurysm involving the root of left common carotid artery underwent radical operation from February 1997 to June 2004. The operation was performed via a midline incision on thoracic wall, the heart and the trunk of major vessels were exposed after the heart sac and its reflection being incised and divided, the incision were extended to neck allowing a full expose of entire aneurysm. The aneurysm was removed from aortic arch after the establishment of ascending aorta and internal carotid artery bypass through the autograft of great saphenous vein. Results All cases cured and discharged in day 9 postoperatively, and no recurrence observed within 8 months, 5 years and 7 years follow-up. Conclusion Ascending aorta and internal carotid artery bypass through venous autograft in the radical operation for giant carotid aneurysm involving the root of left common carotid artery via midline incision demonstrate the advantages of sufficient expose, simple manipulation, less invasion and rapid recovery.