在A型剖析中重新进行部分大动脉根重塑,并进行大动脉左心房
Suguru Ohira1, Vasiliki Gregory2, David Spielvogel1
1Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA New York Medical College School of Medicine, Valhalla, NY, USA.
概括
本案例研究详细介绍了先前冠状动脉旁路移植的患者复杂的大动脉解剖和左大动脉心房的手术修复. 成功的干预涉及到大动脉根改造和移植重新植入.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 大动脉外科手术
背景情况:
- 一名72岁的男性有三重血管冠状动脉旁路移植 (CABG) 病史,呈现了DeBakey II型大动脉剖析.
- 该患者还患有大动脉左心房和专利绕道移植,由需要输管治疗的肺复杂化.
研究的目的:
- 描述了一种罕见的主动脉解剖和主动脉左心房囊组合在专利绕道移植的患者的手术管理.
- 要突出在这个复杂的场景中用于大动脉根改造, hemiarch 修复和移植管理的技术.
主要方法:
- 患者接受了右下动脉的管治疗,随后进行了大动脉切割和大动脉左心房的初级关闭.
- 在中度低温和前级大脑输液下,进行了部分大动脉根改造,并进行了委托式悬浮和 Hemiarch 修复.
- 使用卡雷尔补丁技术重新植入沙芬静脉移植,其中一个需要插入达克朗移植.
主要成果:
- 大动脉左心房囊成功关闭.
- 整骨架的修复工作已经完成,并重建了软静脉移植.
- 患者的旁路移植,包括左侧内部乳腺动脉和沙芬静脉移植,在术后仍然具有专利性.
结论:
- 复杂的大动脉解剖和左大动脉心房可以通过多步骤的手术方法成功管理.
- 在主动脉修复过程中,对专利冠状动脉旁路移植的仔细管理至关重要.
- 大动脉根改造和脑管修复技术在解决这些具有挑战性的病理方面是有效的.
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