DebakeyⅡ型夹层动脉瘤合并弓降部真性动脉瘤的手术治疗

Surgical treatment of DeBakey type Ⅱ aortic dissection combined with true aneurysm in the distal aortic arch: a case report

DebakeyⅡ型夹层动脉瘤合并弓降部真性动脉瘤的病例临床上非常罕见,由于其病变的复杂性,手术治疗的难度和风险都很大。作者成功治疗了一例23岁DebakeyⅡ型夹层动脉瘤合并弓降部巨大真性动脉瘤的病例(6岁时曾因室间隔缺损接受心脏直视手术)。手术方法为"主动脉瓣置换+升主动脉置换+全弓置换术",体外循环采用深低温停循环选择性脑灌注。术后无明显并发症发生,随访半年效果良好。

DeBakey type Ⅱ aortic dissection combined with true aneurysm in the distal aortic arch is a very rare condition, and due to the complicated pathology,its surgical intervention can be difficult and risky.We report a case with this pathology in a 23-year-old man,who received a previous open heart surgery for ventricular septal defect at the age of 6 years.Aortic valve,ascending aorta and total aortic arch replacements were performed.Cardiopulmonary bypass （CPB） including deep hypothermic circulatory arrest with selective antegrade cerebral perfusion was used.No postoperative complications occurred,and the follow-up examination at 6 months after the operation showed good therapeutic results.