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双边关动脉 perfusion 在总弓置换中的双边关动脉 perfusion

Yoshiharu Nishimura¹, Kentaro Honda¹, Mitsuru Yuzaki¹

¹Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan.

The Annals of thoracic surgery

|May 29, 2024

概括

在全面门置换期间双边关动脉管显著降低了永久神经缺陷的风险. 这种方法还缩短了心肺绕道时间,改善了患者的治疗结果.

科学领域:

心血管外科心血管外科
神经学神经学
血管外科血管外科

背景情况:

动脉通道部位对于在整体门置换手术中预防脑梗塞至关重要.
对双边关动脉,大腿动脉和中央管之间的结果进行比较至关重要.

研究的目的:

为了比较使用不同动脉管部位的全门置换的结果.
评估双侧关动脉管在预防脑梗塞方面的有效性.

主要方法:

一项对242名接受全门置换的患者进行的研究,根据管部位分为三个组:双侧关动脉 (124名患者),大腿动脉 (88名患者) 和中央 (30名患者).
在所有参与者中,选择性脑输液用于保护大脑.
分析了包括术后脑梗塞在内的手术结果,并将其与不同组进行了比较.

主要成果:

双侧关动脉组表现出显著缩短心肺旁路和下体循环停止时间.
永久性神经缺陷的发生率在双侧关动脉组 (0.8%) 与中央管组 (13%) 相比显著较低.
双边关动脉输液被确定为预防永久神经缺陷的重要因素 (赔率比0.10,P = .03).

结论:

技术进步,包括双侧关动脉输液和冷大象干技术,与心肺绕道时间的缩短有关.
这些技术与在接受全门置换的患者中预防术后脑梗塞有关.

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