Surgical repair of left-sided cervical aortic arch aneurysm
10.3760/cma.j.issn.1001-4497.2016.07.003
- VernacularTitle:左颈位主动脉弓动脉瘤的外科治疗
- Author:
Tie ZHENG
;
Yongliang ZHONG
;
Ruidong QI
;
Lijian CHENG
;
Yipeng GE
;
Lei CHEN
;
Wei LIU
;
Chengnan LI
;
Xiaoyan XING
;
Junming ZHU
;
Lizhong SUN
- Publication Type:Journal Article
- Keywords:
Cervical aortic arch;
Aortic arch malformation;
Aneurysm;
Cardiac surgical procedures
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2016;32(7):391-394
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize our experience of surgical repair for cervical aortic arch(CAA) aneurysm and eval-uate early and midterm results of these patients.Methods From January 2010 to December 2014, 22 patients with left-sided CAA aneurysm admitted in our center.There were 6 male and 16 female patients with a mean age of(34.09 ±13.14) years. Comorbidities included pseudocoarctation in 9 patients, hypertension in 4 patients, and aortic valve insufficiency, Stanford type B aortic dissection and middle cerebral artery aneurysm each had 1 patient.All of the patients underwent surgical aortic arch re-construction using artificial graft replacement.Among them, 4(4/22, 18.18%) were performed under moderate hypothermic circulatory arrest(MHCA) combined with selective antegrade cerebral perfusion(SACP) via a median sternotomy, and concom-itant aortic valve replacement(AVR) was implemented in 1 patient.18(18/22, 81.82%) were performed via posterolateral left thoracotomy through the 4th intercostal space, and adjunct methods applied included partial CPB and “simple clamping” in 10 and 8 of these patients respectively.Results The average mechanical ventilation time and ICU stay time was (13.05 ± 4.73)h and(19.14 ±8.08) h respectively.1 patient required repeat thoracotomy for bleeding, 1 patient with delayed wound healing and 1 patient suffered transient liver dysfunction.There were no in-hospital deaths.Mean follow-up time was 34.73 months, and 3 patients were lost during follow-up.There were no late deaths during follow-up.Conclusion Repair of CAA is indicated for the patients with arch aneurysm formation .According to the locations and types of aneurysms and other concomi-tant proximal cardiovascular diseases, performing one-stage surgical aortic arch reconstruction with individualized incisions , ad-junct methods and operative procedures can obtain satisfactory clinical outcomes in patients with CAA aneurysm .
