胸主动脉腔内修复术治疗复杂性胸主动脉夹层的临床疗效-中国循环杂志.pdf

中国循环杂志 2016 年 8 月 第 31 卷 第 8 期（总第 218 期）Chinese Circulation Journal，August，2016，Vol. 31 No.8（Serial No.218） 789 临床研究 胸主动脉腔内修复术治疗复杂性胸主动脉夹层的临床疗效 朱水波，朱健，郗二平，张瑜，周孜孜，许贵华，李雪梅 摘要 目的：探讨胸主动脉腔内修复术（TEVAR）治疗复杂性胸主动脉夹层的临床疗效，报道相关临床经验。 方法：回顾性分析 2011-02 至 2015-10 因复杂性胸主动脉夹层在我院接受 TEVAR 治疗的 56 例患者的病历资料， 分析其手术方式的选择及原因。 结果：56 例复杂性胸主动脉夹层患者中 21 例主动脉弓解剖条件复杂，行 TEVAR7 例，行 TEVAR、封闭左锁骨下 动脉 14 例；主动脉夹层形态复杂 16 例，行 TEVAR5 例，行 TEVAR、封闭左锁骨下动脉 11 例；夹层破口累及主动脉弓 19 例，行主动脉弓分支血管旁路术 +TEVAR17 例，预开窗血管支架的 TEVAR 2 例。所有手术均获成功，无严重并发症 发生。 结论：TEVAR 是治疗复杂性胸主动脉夹层的一种快速、有效的手术方式，可以通过封闭左锁骨下动脉、分支血管 旁路术、血管支架改良等方式扩大其应用范围。 关键词 主动脉瘤 , 胸；血管内手术；Hybrid 手术 Clinical Efficacy of Thoracic Endovascular Aortic Repair for Treating the Patients With Complicated Thoracic Aortic Dissection ZHU Shui-bo, ZHU Jian, XI Er-ping, ZHANG Yu, ZHOU Zi-zi, XU Gui-hua, LI Xue-mei. Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of Guangzhou Command, Wuhan (430070), Hubei, China Corresponding Author: XI Er-ping, Email: xierping@126.com Abstract Objective: To investigate the clinical efficacy of thoracic endovascular aortic repair (TEVAR) for treating the patients with complicated thoracic aortic dissection and to report the relevant clinical experiences. Methods: We retrospectively analyzed the records of 56 patients with complicated thoracic aortic dissection who received the operation of TEVAR in our hospital from 2011-02 to 2015-10 in order to analyze their operation methods with reasons. Results: There were 21 patients with complex anatomic conditions for aortic arch, 7 of them received TEVAR and 14 received TEVAR with covered left subclavian artery; 16 patients with complex shape of aortic dissection, 5 of them received TEVAR and 11 received TEVAR with covered left subclavian a