Stanford B 型主动脉夹层腔内修复术后并发 A 型夹层的外科治疗_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

李树春 , 周庆 , 潘俊 , 曹海龙 ,  王东进

南京大学医学院附属鼓楼医院心胸外科江苏省大血管疾病诊疗中心（南京 210008）;

Corresponding author：

王东进, Email: gldjw@163.com

Keywords：

主动脉夹层; Stanford A 型; Stanford B 型; 胸主动脉腔内修复术

DOI：

10.7507/1007-4848.201810066

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目的总结 Stanford B 型主动脉夹层胸主动脉腔内修复术（TEVAR）后并发 A 型夹层的临床特点及外科治疗经验。方法自 2013 年 11 月至 2018 年 3 月，南京鼓楼医院外科治疗 Stanford B 型主动脉夹层 TEVAR 术后并发的 A 型夹层患者 14 例，其中男 13 例、女 1 例，年龄 24～66（52±3）岁，合并高血压 13 例，糖尿病 2 例，马方综合征 1 例。所有患者在深低温停循环选择性脑灌注下施行手术，近心端 13 例行升主动脉置换术，1 例行 Bentall 术。共实施全弓置换加象鼻手术 13 例，弓部开窗支架植入术 1 例。结果全组无死亡，1 例术后右上肢单瘫，1 例术后血行感染，1 例出现右侧偏瘫及肾功能不全行肾脏替代治疗。随访 6～45 个月，随访期间 1 例患者术后 1 个月因原介入支架远端胸降主动脉发生新的夹层再次行 TEVAR，其余患者 CT 血管造影检查未见吻合口造影剂渗漏及人工血管扭曲。结论 B 型主动脉夹层 TEVAR 术后并发 A 型夹层及时给予外科手术治疗可取得良好疗效。

Citation： 李树春, 周庆, 潘俊, 曹海龙, 王东进. Stanford B 型主动脉夹层腔内修复术后并发 A 型夹层的外科治疗. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(8): 826-828. doi: 10.7507/1007-4848.201810066 Copy

1.	Fattori R, Cao P, De Rango P, et al. Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol, 2013, 61(16): 1661-1678.
2.	Lou X, Chen EP, Duwayri YM, et al. The impact of thoracic endovascular aortic repair on long-term survival in type B aortic dissection. Ann Thorac Surg, 2018, 105(1): 31-38.
3.	Chen Y, Zhang S, Liu L, et al. Retrograde type A aortic dissection after thoracic endovascular aortic repair: a systematic review and meta-analysis. J Am Heart Assoc, 2017, 6(9): pii: e004649.
4.	Canaud L, Marty-Ane C, Alric P. Letter by Canaud et al regarding article, "Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications". Circulation, 2010, 121(20): e413.
5.	Eggebrecht H, Nienaber CA, Neuhäuser M, et al. Endovascular stent-graft placement in aortic dissection: a meta-analysis. Eur Heart J, 2006, 27(4): 489-498.
6.	Kpodonu J, Preventza O, Ramaiah VG, et al. Retrograde type A dissection after endovascular stenting of the descending thoracic aorta. Is the risk real? Eur J Cardiothorac Surg, 2008, 33(6): 1014-1018.
7.	Dong ZH, Fu WG, Wang YQ, et al. Retrograde type A aortic dissection after endovascular stent graft placement for treatment of type B dissection. Circulation, 2009, 119(5): 735-741.
8.	Lu S, Lai H, Wang C, et al. Surgical treatment for retrograde type A aortic dissection after endovascular stent graft placement for type B dissection. Interact Cardiovasc Thorac Surg, 2012, 14(5): 538-542.
9.	Scheinert D, Krankenberg H, Schmidt A, et al. Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta. Eur Heart J, 2004, 25(8): 694-700.
10.	Liu L, Zhang S, Lu Q, et al. Impact of oversizing on the risk of retrograde dissection after TEVAR for acute and chronic type B dissection. J Endovasc Ther, 2016, 23(4): 620-625.
11.	陆清声. Stanford B型主动脉夹层腔内修复术中支架种类及尺寸的选择策略. 中华外科杂志, 2018, 56(10): 753-755.

1. Fattori R, Cao P, De Rango P, et al. Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol, 2013, 61(16): 1661-1678.
2. Lou X, Chen EP, Duwayri YM, et al. The impact of thoracic endovascular aortic repair on long-term survival in type B aortic dissection. Ann Thorac Surg, 2018, 105(1): 31-38.
3. Chen Y, Zhang S, Liu L, et al. Retrograde type A aortic dissection after thoracic endovascular aortic repair: a systematic review and meta-analysis. J Am Heart Assoc, 2017, 6(9): pii: e004649.
4. Canaud L, Marty-Ane C, Alric P. Letter by Canaud et al regarding article, "Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications". Circulation, 2010, 121(20): e413.
5. Eggebrecht H, Nienaber CA, Neuhäuser M, et al. Endovascular stent-graft placement in aortic dissection: a meta-analysis. Eur Heart J, 2006, 27(4): 489-498.
6. Kpodonu J, Preventza O, Ramaiah VG, et al. Retrograde type A dissection after endovascular stenting of the descending thoracic aorta. Is the risk real? Eur J Cardiothorac Surg, 2008, 33(6): 1014-1018.
7. Dong ZH, Fu WG, Wang YQ, et al. Retrograde type A aortic dissection after endovascular stent graft placement for treatment of type B dissection. Circulation, 2009, 119(5): 735-741.
8. Lu S, Lai H, Wang C, et al. Surgical treatment for retrograde type A aortic dissection after endovascular stent graft placement for type B dissection. Interact Cardiovasc Thorac Surg, 2012, 14(5): 538-542.
9. Scheinert D, Krankenberg H, Schmidt A, et al. Endoluminal stent-graft placement for acute rupture of the descending thoracic aorta. Eur Heart J, 2004, 25(8): 694-700.
10. Liu L, Zhang S, Lu Q, et al. Impact of oversizing on the risk of retrograde dissection after TEVAR for acute and chronic type B dissection. J Endovasc Ther, 2016, 23(4): 620-625.
11. 陆清声. Stanford B型主动脉夹层腔内修复术中支架种类及尺寸的选择策略. 中华外科杂志, 2018, 56(10): 753-755.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Stanford B 型主动脉夹层腔内修复术后并发 A 型夹层的外科治疗

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