在斯坦福A型大动脉剖析大动脉门替换期间,隔离的左脊椎动脉的转移
Fangyuan Jia1, Gang Qiao1, Hong Wang2
1Department of Aortic Surgery, Central China Subcenter of National Center for Cardiovascular Diseases, Henan Cardiovascular Disease Center, Fuwai Central-China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China.
Journal of thoracic disease
|October 29, 2025
概括
在大动脉门修复期间管理孤立的左脊椎动脉 (ILVA) 是可行的. 在A型大动脉解剖 (TAAD) 修复中ILVA转化显示出高的成功率和通透率,可接受的安全性.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 胸部外科手术 胸部外科手术
背景情况:
- 孤立的左脊椎动脉 (ILVA) 在大动脉门修复中提出了手术挑战.
- 甲型大动脉解剖 (TAAD) 需要复杂的手术管理,通常涉及大动脉门.
研究的目的:
- 为了评估ILVA的管理在经过冷大象干 (太阳的手术) 或TAAD的II型混合大动脉门修复的全动脉门置换患者.
- 评估ILVA转移在该患者队列中的可行性,安全性和有效性.
主要方法:
- 对672名TAAD患者进行了回顾性观察队列研究.
- 在2019年2月至2023年8月期间接受了开放性手术的34名ILVA患者 (5.06%) 的分析.
- 收集的数据包括人口统计,并发症,成像,手术细节,术后结果和随访.
主要成果:
- 34名ILVA患者接受了Sun的手术 (n=32) 或II型混合修复 (n=2).
- 伊尔瓦的实施实现了100%的初级技术成功率.
- 术后死亡率为8.8% (3/34),没有报告ILVA特异性并发症;长期随访显示专利转移ILVA,没有主动脉相关的再干预.
结论:
- 在太阳的手术或TAAD的II型混合动力大动脉门修复过程中,ILVA转移是一种可行的和安全的技术.
- 这项研究证明了这种方法的有效性,具有良好的长期通透性,并且没有与移植动脉相关的重大不良事件.
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