为大动脉门病理加热冷的大象
Laura Besola1, Luca Biasci1, Chiara Mangifesta1
1Cardiac Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy.
Annals of cardiothoracic surgery
|October 16, 2025
概括
非常轻度的低温循环停止 (MiHCA) 在冷象牙 (FET) 过程中对于大动脉门病理是安全的. 核心温度高于30°C与双边脑 perfusion 产生最佳的结果在急性大动脉综合征.
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
- 血管外科 血管外科
背景情况:
- 冷大象干 (FET) 技术是对大动脉门病理的标准.
- 实践正在从深度转向中度低温循环停止 (HCA).
- 这种转变可能会影响神经和结局.
研究的目的:
- 在接受FET的患者中评估非常轻度HCA (MiHCA) 的安全性和结果.
- 评估HCA期间核心温度≥30°C对神经和功能的影响.
主要方法:
- 对92名连续接受FET和HCA治疗的患者进行了回顾性分析.
- 在所有病例中都使用了前期选择性脑输液.
- 主要终点包括急性损伤 (AKI),神经事件和出血.
主要成果:
- 膀平均温度为30±1.6°C;平均CPB和CA时间分别为219±78和15分钟.
- 卒中发生在15%的患者中 (1%致死,9%致残).
- 需要血过的功能障碍发生在6%的患者中;30天死亡率为14%.
结论:
- 非常轻度的HCA (核心温度≥30°C) 与双边前级大脑输液是安全的FET手术.
- 这种策略与有利的结果有关,特别是在急性大动脉综合征中.
- GERAADA评分预测了神经事件和出血;下降大动脉参与预测了功能障碍.
相关概念视频
Thoracic Aorta
The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...


