深低温停循环三分支主动脉弓覆膜支架植入治疗急性A型主动脉夹层.pdfVIP

Treatment for acute type A aortic dissection using implantation of triple － branched aortic arch covered stent under deep hypothermic circulatory arrest Postgraduate：Chen Hongwei Advisor： Chen Liangwan Professor Abstract Objectives: To summary the clinical experience of Treatment for acute type A aortic dissection using implantation of triple － branched aortic arch covered stent under deep hypothermic circulatory arrest. Methods: Between February 2010 and October 2011，50 well selected patients with Stanford type A aortic dissection Underwent open three branches aortic arch covered stent graft implantation for arch reconstruction．When core cooling to 20℃ nasopharyngeal temperature， deep hypothermic-circulatory arrested，Selected cerebra perfusion，and the ascending aorta was transected．three branches aortic arch covered stent graft was inserted into the true lumen of the arch and descending aorta．The transected stump of the ascending aorta was reconstructed by end－to－end anastomosis of inner proximal stent graft. Result : Therewere no deaths during operating. Three branches aortic arch covered stent graft was technically successful in all patients．The mean cardiopulmonary bypass time ，aortic cross clamp time ，circulatory arrested time，average selective cerebral perfusion time were(192．30 ±32．56)min，(85．88±18．65)min，(8．12±5．59)min，(35．8±6．78)min， respectively ．Drainage volume of pericardial effusion and pleural effusion after surgery was （636.62±438.61ml）. Three patients died during hospitalization, the causes of death 4 were acute renal failure, severe lung infection and rupture of abdominal aortic dissection. The 47 patients were follow-up in outpatient regularly, with no deaths and reoperation cases, no stent-related complications. Review of abdominal aor