Abstract:
Surgery for acute type A aortic dissection is highly challenging, even in expert hands. The goal in such emergency circumstances is primarily to save the patient\'s life. To minimize the perioperative risk, surgeons often choose surgery involving only supracoronary ascending aortic and hemiarch replacement. However, to achieve a successful repair, the extremely fragile dissected aortic layers must be reconstructed proximally and distally. Most of the surgical procedures for patients with acute type A aortic dissection are supracoronary ascending aortic replacements. Thereby, the Florida sleeve procedure is an attractive alternative for reimplanting the entire aortic root into a Dacron graft. This approach has overcome most of the technical problems associated with composite valve graft or valve-sparing procedures. The frozen elephant trunk procedure is particularly appealing for treating acute type A aortic dissection because of its ability to treat malperfusion by encouraging true lumen expansion and potentially reducing longer-term adverse remodelling within the descending aorta.
摘要:
急性A型主动脉夹层的手术非常具有挑战性,即使在专家手中。在这种紧急情况下的目标主要是挽救患者的生命。降低围手术期风险,外科医生通常选择仅涉及冠状动脉上升主动脉和半弓置换的手术。然而,为了实现成功的修复,极其脆弱的主动脉夹层必须在近端和远端重建。急性A型主动脉夹层患者的大多数外科手术是冠状动脉上升主动脉置换术。因此,佛罗里达袖套手术是将整个主动脉根部重新植入Dacron移植物的一种有吸引力的替代方法。这种方法克服了与复合瓣膜移植物或瓣膜保留程序相关的大多数技术问题。冷冻象鼻手术对于治疗急性A型主动脉夹层特别有吸引力,因为它能够通过鼓励真正的管腔扩张来治疗灌注不良,并有可能减少降主动脉内的长期不良重塑。