主动脉根部替换手术93例

Aortic Root Replacement With a Composite Graft Experience in 93 Patients

目的 :探讨主动脉根部替换手术的手术适应证、基本方法和手术技术。 方法 :主动脉根部替换手术 93例 ,平均年龄 41.2岁 (2 3～ 6 9岁 )。对于主动脉夹层或累及主动脉弓的动脉瘤 ,选择右锁骨下动脉插管 ,行象鼻手术时加用股动脉插管。以复合带瓣人工血管行根部替换。 2例合并象鼻手术。 结果 :93例主动脉根部替换手术平均心肌阻断时间 72 .5± 17.9分钟 (42～ 133分钟 ) ,平均体外循环时间 113.6±32 .7分钟 (6 0～ 2 32分钟 )。住院死亡 1例 (1.0 8% )。 8例手术未输血。 结论 :精湛的手术技术和麻醉、体外循环等整体水平的提高是主动脉根部替换手术取得良好效果的关键。

Objective:To study the indication,methods and operative techniques of aortic root replacement. Methods:Ninety three patients with a mean age of 41 2 years (23-69 years) underwent aortic root replacement with composite grafts.In dissecting aortic aneurysm or aortic aneurysm involving the aortic arch,the patients were operated with selective cerebral perfusion via right subclavian artery.We also used femoral arterial cannulation additionally if necessary.The aortic root was replaced with a composite graft.Combined elephant trunk technique in 2 patients. Results:The mean duration of aortic cross clmping was 72 5±17 9 minutes (42-133 minutes),and the mean duration of cardiopulmonary bypass was 113 6±32 7 minutes (60-232 minutes).The hospital mortality rate was 1 08%.Eight patients were free from blood transfusion. Conclusion:The suitable operative method and improved surgical technique are the keys to successful aortic root replacement.