CAJ | 학술논문

自2000年Dorros等报告了国际上第一例腔内修复术治疗升主动脉夹层之后,学者们渐渐探索出了一种新的升主动脉夹层治疗方式.升主动脉位置和形态学特点比较特殊,在应用腔内修复术时应注意如下几点:(1)根据适应证合理针对患者特点个性化选择治疗方式;(2)充分进行术前评估;(3)选择合理的支架与输送系统;(4)选择合理手术入路;(5)术中保证冠状动脉及弓上分支动脉的灌注并保护主动脉瓣的功能;(6)精确定位支架位置;(7)加强中远期随访.总之,应用腔内修复术治疗升主动脉夹层,应把握手术适应证和技术要点,严格根据患者特点合理选择治疗方式,避免治疗误区,提高手术安全性.
자2000년Dorros등보고료국제상제일례강내수복술치료승주동맥협층지후,학자문점점탐색출료일충신적승주동맥협층치료방식.승주동맥위치화형태학특점비교특수,재응용강내수복술시응주의여하궤점:(1)근거괄응증합리침대환자특점개성화선택치료방식;(2)충분진행술전평고;(3)선택합리적지가여수송계통;(4)선택합리수술입로;(5)술중보증관상동맥급궁상분지동맥적관주병보호주동맥판적공능;(6)정학정위지가위치;(7)가강중원기수방.총지,응용강내수복술치료승주동맥협층,응파악수술괄응증화기술요점,엄격근거환자특점합리선택치료방식,피면치료오구,제고수술안전성.
Since 2000 Dorros et al.reported the first case of type A aortic dissection (TAAD) treated with an endovascular repair, surgeons explored a novel treatment option for TAAD gradually.The application of endovascular repair for TAAD highlights some points below which should pay attention to because of the special anatomic location and morphological characteristics of ascending aorta: (1) customized treatment strategy based on the characteristics of patients;(2) pre-operation evaluation;(3) selection of the stent and delivery system;(4) selection of the access sites;(5) preservation of the coronary artery flow, aortic valve function and perfusion of the branch vessels;(6) accurate location of stent-graft;(7) mid-term and long-term follow-up.In a word, it's helpful to avoid misunderstanding in treatment and improve the safety of operation by grasping the indication and the technical points and making the customized treatment strategy based on the characteristics of patients.