单一胸骨上段小切口孙氏手术治疗Stanford A型主动脉夹层

Sun' s procedure for Stanford A type aortic dissection through single upperhemisternotomy approach

目的探讨采用单一胸骨上段第4肋间小切口行孙氏手术治疗StanfordA型主动脉夹层的可行性与安全性。方法2017年9月至2018年4月共58例患者确诊为StanfordA型主动脉夹层,其中男39例,女19例;年龄(46.3±9.5)岁。经单一胸骨上段第4肋间小切口行孙氏手术并记录围术期各种参数。结果全组患者均在单一胸骨上段小切口完成手术,围术期死亡3例(5.2%);体外循环(181.6±25.5)min,主动脉阻断(114.2±19.8)min,停循环(29.0±5.8)min。术后随访2~15个月,无与手术相关的严重不良事件。结论经胸骨上段小切口孙氏手术是一种治疗StanfordA型主动脉夹层安全可靠的手术方式,可有效减少手术创伤、增加患者满意度。

Objective To evaluate the feasibility and safety of Sun' s procedure for Stanford A type aortic dissection through single upperhemisternotomy approach(from the Strernal Notch to the level of fourth intercostal space). Methods58 patients(39 male and 19 female) with Stanford A type aortic dissection were retrospective for this study, who were(46.3±9.5) years old. Sun' s prcedure were carried out through single upperhemisternotomy approach and the perioperative characteristics were recorded. Results All patients were finished Sun' s procedure through single upperhemisternotomy approach, with 5.2% of mortality(3 patients died postoperation). The time of cardiopulmonary bypass, aortic cross clamp and circulation arrest were respectively(181.6±25.5)min,(114.2±19.8)min and(29.0±5.8)min. Non serious adverse event were found after 2 to 15 months follow-up. Conclusion Sun' s procedure through single upperhemisternotomy approach was one of the safe and feasible treatment for Stanford A type aortic dissection, which can reduce the operative wound and improve the patients’ satisfactory.