中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2015年
5期
282-285
,共4页
王晓龙%关欣亮%刘愚勇%郑铁%贡鸣%李海洋%刘欧%张宏家%孙立忠
王曉龍%關訢亮%劉愚勇%鄭鐵%貢鳴%李海洋%劉歐%張宏傢%孫立忠
왕효룡%관흔량%류우용%정철%공명%리해양%류구%장굉가%손립충
冠状动脉受累%冠状动脉分流术%急性Stanford A型主动脉夹层
冠狀動脈受纍%冠狀動脈分流術%急性Stanford A型主動脈夾層
관상동맥수루%관상동맥분류술%급성Stanford A형주동맥협층
Acute coronary involvement%Coronary artery bypass%Acute type A aortic dissection
目的 总结急性Stanford A型主动脉夹层累及冠状动脉的外科治疗方法及结果.方法 回顾2010年3月至2013年8月177例急性Stanford A型主动脉夹层并行孙氏手术患者的临床资料,男130例,女47例;年龄(47.25±12.13)岁.29例累及冠状动脉并接受冠状动脉旁路移植手术.术前5例患者出现急性下壁心肌梗死,2例出现急性前壁或侧壁心肌梗死.手术均在患者送达医院24 h内进行.结果 右冠状动脉受累26例,左冠状动脉受累2例,1例患者双侧冠状动脉受累.22例冠状动脉受累的患者术前无心肌缺血的证据.急性Stanford A型主动脉夹层累及冠状动脉的患者与无冠状动脉受累的患者相比存在更高的院内病死率.结论 急性Stanford A型主动脉夹层一旦累及冠状动脉病死率较高,孙氏手术的同时行冠状动脉旁路移植手术对于挽救此类患者十分重要.
目的 總結急性Stanford A型主動脈夾層纍及冠狀動脈的外科治療方法及結果.方法 迴顧2010年3月至2013年8月177例急性Stanford A型主動脈夾層併行孫氏手術患者的臨床資料,男130例,女47例;年齡(47.25±12.13)歲.29例纍及冠狀動脈併接受冠狀動脈徬路移植手術.術前5例患者齣現急性下壁心肌梗死,2例齣現急性前壁或側壁心肌梗死.手術均在患者送達醫院24 h內進行.結果 右冠狀動脈受纍26例,左冠狀動脈受纍2例,1例患者雙側冠狀動脈受纍.22例冠狀動脈受纍的患者術前無心肌缺血的證據.急性Stanford A型主動脈夾層纍及冠狀動脈的患者與無冠狀動脈受纍的患者相比存在更高的院內病死率.結論 急性Stanford A型主動脈夾層一旦纍及冠狀動脈病死率較高,孫氏手術的同時行冠狀動脈徬路移植手術對于輓救此類患者十分重要.
목적 총결급성Stanford A형주동맥협층루급관상동맥적외과치료방법급결과.방법 회고2010년3월지2013년8월177례급성Stanford A형주동맥협층병행손씨수술환자적림상자료,남130례,녀47례;년령(47.25±12.13)세.29례루급관상동맥병접수관상동맥방로이식수술.술전5례환자출현급성하벽심기경사,2례출현급성전벽혹측벽심기경사.수술균재환자송체의원24 h내진행.결과 우관상동맥수루26례,좌관상동맥수루2례,1례환자쌍측관상동맥수루.22례관상동맥수루적환자술전무심기결혈적증거.급성Stanford A형주동맥협층루급관상동맥적환자여무관상동맥수루적환자상비존재경고적원내병사솔.결론 급성Stanford A형주동맥협층일단루급관상동맥병사솔교고,손씨수술적동시행관상동맥방로이식수술대우만구차류환자십분중요.
Objective Acute type A aortic dissection associated with coronary involvement is relatively rare,but it is a potentially fatal condition.Surgical treatment of these patients relied on coronary revascularization.However,coronary revascularization during aortic surgery poses a considerable surgical risk.Methods Between March 2010 and August 2013,we recruited 29 patients with coronary involvement caused by Acute type A aortic dissection who had undergone aortic surgery.All procedures were done on an emergency basis within 24 hours after the patient' s arrival.Results At admission,5 patients had acute inferior myocardial infarction and anterior or lateral in 2 before surgery.The right coronary artery was involved in 26 patients,the left in 2 patients,and both coronary arteries in 1 patient.22 patients with coronary involvement presented with no evidence of myocardial ischemia.Acute type A aortic dissection with coronary involvement is associated with higher in-hospital mortality rate.Conclusion In conclusion,coronary involvement due to acute type A aortic dissection does not always cause coronary malperfusion.Acute type A aortic dissection with coronary involvement is associated with high mortality rate.Aggressive coronary revascularization is essential to salvage these critically ill patients.
