Cabrol手术治疗Stanford A型主动脉夹层的疗效分析

Clinical Outcomes of Cabrol Procedure for the Treatment of Stanford Type A Aortic Dissection

目的总结并分析Cabrol手术用于Stanford A型主动脉夹层患者进行主动脉根部处理的疗效及效果。方法回顾性分析2009年1月至2014年4月广东省心血管病研究所心外科行Cabrol术治疗Stanford A型主动脉夹层37例患者的临床资料,其中男34例、女3例,年龄21~66岁,发病至手术时间为（15.2±28.5）d。全组均行Cabrol手术处理主动脉根部,根据主动脉弓受累情况,行右半弓置换或全主动脉弓置换加降主动脉腔内支架隔绝术。结果全组手术均成功,行单纯Cabrol术4例,其中1例行Bentall术中转行Cabrol术,右半弓置换术10例,全主动脉弓置换加降主动脉腔内支架隔绝术23例。二次开胸止血1例（2.7%）,术后死亡4例（10.8%）;随访1~24个月,随访期间死亡2例。结论 Cabrol手术治疗Stanford A型主动脉夹层效果良好,远期人造血管通畅,冠状动脉无压迫,效果满意。

Objective To analyze the clinical outcomes of Cabrol procedure for the treatment of Stanford type A aortic dissection. Methods Clinical data of 37 patients with Stanford type A aortic dissection underwent Cabrol procedure at the Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute from January 2009 to April 2014 were retrospectively analyzed. There were 34 males and 3 females aged at 21 to 66 years. The average interval time from onset to getting operation was 15.2±28.5 days. All patients received Cabrol procedure was performed for aortic root. According to different aortic arch conditions, hemiarch replacement or total arch replacement combined endovascular aortic repair with stent were performed. Results All the operations were successfully performed including isolated Cabrol procedure in 4 patients, right hemiarch replacement in 10 patients and total arch replacement combined endovascular aortic repair with stent in 23 patients. One patient（2.7%） underwent reexploration for postoperative bleeding. Postoperative mortality was 10.8%（4/37）. Follow-up duration was 1-24 months, 2 patients died during followup. Conclusion Cabrol procedure has satisfactory clinical outcomes for Stanford type A AD and long-term patency of aortic without coronary oppression.