急性Stanford A型主动脉夹层手术中迷走左椎动脉的处理
摘要
<正>主动脉夹层是指主动脉内膜撕裂,血液经内膜破口进入中膜顺行或逆行剥离主动脉管壁,形成真假腔,一旦破裂几乎无生还的可能。其中以急性Stanford A型主动脉夹层(AAD)最为凶险,未经治疗的AAD患者,死亡率以每小时1%~2%递增~([1]),病死率极高,接受外科手术治疗是改善其预后的主要方法~([2])。左椎动脉是大脑血液供应的重要一支,正常起源于左锁骨下动脉。迷走左椎动脉起源异常,常
引文
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[3] JAYASABARINATHAN M, JEEVAMANI S G. A study on anatomical and morphological variations of the origin of left vertebral artery from the arch of aorta[J]. J Evo Med Dent Sci,2015,4:5109-5114.
[4] NAITO Y,NAKAJIMA M,INOUE H,et al. Successfultreatment of a mycotic aorticarch aneurysmassociated with an isolated leftvertebral artery[J]. J Thorac Cardiovasc Surg,2003,126:883-885.
[5]胡小平,王志维,邓宏平,等.改良全主动脉弓置换治疗老年Stanford A型主脉夹层[J].临床外科杂志,2016,24(10):777-779.
[6]胡知朋,张敏,王志维,等.急性A型主动脉夹层合并腹腔脏器灌注不良的治疗[J].实用医学杂志,2017,33(23):4011-4012.
[7] QI R,SUN L,ZHU J,et al.Total arch replacement inpatients with aortic dissection with an isolated left vertebralartery[J].Ann Thorac Surg,2013,95:36-40
[8] BLUMBERG S N,ADELMAND M A,MALDONADO T S. Aberrant left vertebral artery transposition and concomitantcarotid-subclavian bypass for treatment of acuteintramuralhematoma with thoracic endovascular aortic repair[J].J Vascul Surg,2017,65(3):860-864.
[9]徐志云,张浩. Stanford A型主脉夹层弓部病变的手术策略[J].北京医学,2016,35(7):554-556
[10] YOSHIYUKI Y,KURISU K,KIMURA S,et al. Reconstruction of an isolated left vertebral artery during totalaortic arch replacement to preserve cerebral perfusion[J]. Indian J Thorac Cardiovasc Surg,2016,32(4):272-274.
[11] YAMASHIRO S, KUNIYOSHI Y,ARAKAKI K,et al. Total arch replacementwith associated anomaly ofthe left vertebral artery[J]. Ann Thorac Cardiovasc Surg,2010,16:216-219.
[12] SUZUKI K,KAZUI T, BASHAR A H,et al. Total aortic arch replacement in patientswith arch vessel anomalies[J]. Ann Thorac Surg,2006,81(6):2079-2083.
[2]李春生,严中亚,卢中,等.个体化开窗覆膜支架在Stanford A型主动脉夹层中的应用[J].实用医学杂志,2018,34(3):393-396.
[3] JAYASABARINATHAN M, JEEVAMANI S G. A study on anatomical and morphological variations of the origin of left vertebral artery from the arch of aorta[J]. J Evo Med Dent Sci,2015,4:5109-5114.
[4] NAITO Y,NAKAJIMA M,INOUE H,et al. Successfultreatment of a mycotic aorticarch aneurysmassociated with an isolated leftvertebral artery[J]. J Thorac Cardiovasc Surg,2003,126:883-885.
[5]胡小平,王志维,邓宏平,等.改良全主动脉弓置换治疗老年Stanford A型主脉夹层[J].临床外科杂志,2016,24(10):777-779.
[6]胡知朋,张敏,王志维,等.急性A型主动脉夹层合并腹腔脏器灌注不良的治疗[J].实用医学杂志,2017,33(23):4011-4012.
[7] QI R,SUN L,ZHU J,et al.Total arch replacement inpatients with aortic dissection with an isolated left vertebralartery[J].Ann Thorac Surg,2013,95:36-40
[8] BLUMBERG S N,ADELMAND M A,MALDONADO T S. Aberrant left vertebral artery transposition and concomitantcarotid-subclavian bypass for treatment of acuteintramuralhematoma with thoracic endovascular aortic repair[J].J Vascul Surg,2017,65(3):860-864.
[9]徐志云,张浩. Stanford A型主脉夹层弓部病变的手术策略[J].北京医学,2016,35(7):554-556
[10] YOSHIYUKI Y,KURISU K,KIMURA S,et al. Reconstruction of an isolated left vertebral artery during totalaortic arch replacement to preserve cerebral perfusion[J]. Indian J Thorac Cardiovasc Surg,2016,32(4):272-274.
[11] YAMASHIRO S, KUNIYOSHI Y,ARAKAKI K,et al. Total arch replacementwith associated anomaly ofthe left vertebral artery[J]. Ann Thorac Cardiovasc Surg,2010,16:216-219.
[12] SUZUKI K,KAZUI T, BASHAR A H,et al. Total aortic arch replacement in patientswith arch vessel anomalies[J]. Ann Thorac Surg,2006,81(6):2079-2083.