主动脉外科手术96例治疗体会

Experiences of Aortic Surgery in 96 Patiens

目的总结2004年3月至2010年1月96例主动脉外科手术治疗的体会.方法胸主动脉瘤患者81例,升主动脉瘤样扩张合并瓣膜病变患者15例;Bentall手术42例,Cabrol手术29例,(其中改良Cabrol手术9例),Wheat手术13例,升主动脉置换术7例,升主动脉成行术15例;其中同期行全弓置换术6例,半弓置换术6例,象鼻手术3例,冠状动脉旁路移植术4例,升主动脉-腹主动脉人工血管旁路手术2例,降主动脉置换术1例.结果 92例生存,1例手术死亡,3例术后早期死亡,住院死亡率为4.1%.结论应根据主动脉病变的性质、部位及夹层累及的范围等采用不同的手术方式,准确可靠的吻合技术、先进的人工材料与技术设备的应用使手术更为安全。

Objective To summarize the experiences of aortic surgery in 96 patients from March 2004 to January 2010.Methods We selected 81 patients with thoracic aortic aneurysm and 15 patients with ascending aortic aneurysm combined with valvular disease.We conducted Bentall operation in 42 patients,Cabrol operation in 29 patients（including improved Cabrol operation in 9 patients）,Wheat operation in 13 patients,ascending aorta replacement in 7 patients,ascending aorta plasty in 15 patients.Among them,6 patients received the whole aortic arch replacement,6 patients received half aortic arch replacement,3 patients received elephant trunk operation,4 patients received coronary artery bypass graft,2 patients received ascending aorta-abdominal aorta artificial blood vessel bypass graft,and 1 patient received descending aorta replacement.Results 92 patients survived after surgery,1 patient died in surgery,3 patients died in the early stage after surgery.The in-hospital mortality was 4.1%.Conclusions The appropriate surgery should be adopted according to the characteristics and location of aortic aneurysm,and involved extent in dissection of aorta.Accurate and reliable anastomosis,advanced artificial materials and equipments can make the aortic surgery safer.