Clinical treatment of acute type-A aortic dissection with lower limb malperfusion
10.3760/cma.j.issn.1001-4497.2018.10.005
- VernacularTitle:急性A型主动脉夹层合并下肢缺血的治疗
- Author:
Cong CUI
1
;
Li ZHANG
;
Xia GAO
;
Xianghui ZHANG
;
Changbo XIAO
;
Wei LU
;
Gang WU
;
Pingfan WANG
Author Information
1. 河南省胸科医院心外科
- Keywords:
Aortic dissection;
Lower limb malperfusion;
Surgical treatment
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(10):593-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the treatment experience of acute type-A aortic dissection with lower limb malperfusion.Methods From December 2012 to December 2016,479 cases of acute type A aortic dissection were treated surgically,including 39 patients with lower limb ischemia,including 27 males and 12 females,with mean age of(5 1.4 ± 12.4) years.All patients were treated with deep hypothermic circulatory arrest and were treated with single pump,double-tube and double-injected limbs.According to the patient's lower limb ischemia time,symptoms and signs,limb ischemia was assessed.If necessary,femoral artery-femoral arterial bypass was performed.For patients undergoing femoral arterial-femoral prosthetic bypass during the same period,postoperative follow-up monitoring,if necessary,secondary femoral-femoral arterial vascular bypass or osteofascial decompression.Results Early mortality rate was 17.9％ (7/39).32 cases of postoperative survival.The follow-up rate was 93.8％ (30/32),3 months to 3 years after the operation,the results were satisfactory.The over lower limb malperfusion recovery rate of follow-up patients was 96.7％ (29/30).Conclusion Positive operation for acute type-A aortic dissection with lower limb malperfusion is safe,feasible and effective.Concomitant or secondary bypass procedures are also possible to restore distal perfusion when necessary.Comprehensive evaluation of patient' s status is strongly recommended for optimal surgical decision making.
