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技术说明:在全弧内血管修复后进行开放式上升大动脉和门修复
Florent Porez1, Robert Pruna-Guillen1, Julien Guihaire1
1Aortic Center, Department of Vascular Surgery, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Université Paris Saclay, Le Plessis-Robinson, France.
概括
门分支内血管修复 (B-TEVAR) 是开放门修复的替代方案. 在B-TEVAR后,复杂的重复手术涉及上升性大动脉 (AA) 和心脏门,使用所述的手术技术是可行的.
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
- 医疗器械 医疗器械
背景情况:
- 门分支内血管修复 (B-TEVAR) 是一种新兴的替代高风险患者的开放门修复.
- 越来越多地使用B-TEVAR将导致涉及上升大动脉 (AA) 和心脏门的更复杂的重新手术.
- 在B-TEVAR之后的开放AA修复中,没有确定的技术.
研究的目的:
- 描述之前B-TEVAR.患者开放的上升大动脉 (AA) 和门修复的手术技术.
- 为在B-TEVAR.之后管理复杂的重新操作提供技术见解.
主要方法:
- 之前有B-TEVAR的两名患者接受了开放的AA和门手术.
- 技术包括选择性双管输液的循环停止和偏远大动脉控制和选择性脑干 (BCT) 输液的股骨-股骨绕道.
- 考虑到内移植位置和分支方向的详细外科规划至关重要.
主要成果:
- 这两次复杂的重新操作都在技术上取得了成功.
- 一名患者无事恢复;另一个患者长期住在ICU,但完全康复.
- 术前CT与3D重建对于手术规划至关重要.
结论:
- 在B-TEVAR之后,上升大动脉 (AA) 和门修复是可行的.
- 这些案例为管理具有挑战性的重新运营提供了宝贵的见解,因为B-TEVAR的采用越来越多.
- 量身定制的手术方法是强制性的,重点是内移植分支的位置和方向.
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