主动脉弓部瘤及降部瘤的外科治疗

Surgical treatment of aortic aneurysm involving aortic arch and descending aorta

目的 :总结主动脉弓部瘤及降部瘤的外科治疗经验。方法 :4例主动脉弓部瘤及降部瘤患者 ,左心转流 (LAV) 3例 ,深低温停循环和选择性脑灌注 (HCA +SCP) 1例。 3例降主动脉瘤中 ,2例急诊在LAV下血管置换 ,1例择期在LAV下血管置换。 1例弓部瘤急诊在HCA +SCP下行半弓置换。结果 :4例均无手术死亡及脊髓、肾脏损害 ,1例主动脉弓部瘤术后出现脑梗塞。结论 :主动脉弓部瘤及降部瘤外科治疗中 ,选择正确的体外循环方法和适当的外科吻合技术对手术成功有重要的意义。

Objective: To summarize surgical experience in the treatment of aortic aneurysm involving aortic arch and descending aorta. Methods: Four patients (3 male and 1 female with an age between 38 and 63) with aortic aneurysm involving aortic arch and descending aorta received surgical treatment. Of all the patients, 3 were operated on under left ventricle vision CPB, and 1 patient operated on under HCA combined with SCP. Aneurysms ranged from 40 mm to 65 mm in diameter. In the 3 cases with descending aortic aneurysm, 2 emergency cases were operated on under LAV CPB, and 1 case with acute arch dissection aneurysm was operated on under HCA combined with SCP. Results: There were neither operative deaths nor spinal and renal damage due to surgical operation, but there was one case that suffered from cerebral infarction after surgery. Conclusion: Surgical expertise combined with correct methods of CPB and proper anastomosis is of great significance in the treatment of aortic aneurysm involving aortic arch and descending aorta.