"杂交手术"治疗DeBakey Ⅰ型主动脉夹层

目的总结主动脉夹层患者（DeBakeyⅠ型）行人工血管置换同时远端置入血管内支架（即＂杂交手术＂）的治疗体会。方法4例主动脉夹层患者（（DeBakeyⅠ型）行升主动脉并全弓置换加降主动脉支架置入术（其中1例Bentall术）。术后1月及3月复查胸部螺旋CT,了解升主动脉、主动脉弓人工血管及降主动脉血管内支架情况。结果4例患者均手术成功,无严重并发症,体外循环时间227～331min（平均290min）。升主动脉阻断96～275min（平均209min）,所有患者均顺利出院。术后1月及3月复查胸部大血管螺旋CT示人工血管通畅,血管内支架无内瘘及移位,远端假腔明显缩小。结论对于DeBakeyⅠ型主动脉夹层行动脉瘤切除,人工血管置换（全弓）加远端降主动脉支架置入,是一种安全、有效的手术方法。

"Hybrid technique"(thoratic aortic replacement combined with endoluminal stent grafting)for aortic dissection

Objective To summary the experience of concomitant thoratic aortic replacement and endoluminal stent grafting (socalled"Hybrid technique")for aortic dissection. Methods Four patients with Acute DeBakey typeⅠAortic dissection,received as-cending aortic and total aortic arch replacement and endoluminal stent grafting (one case received Bentall and total aortic arch replacement and endoluminal stent grafting). Enhanced electric beam computed tomography (EBCT)was performed in each patient at one month and three months after surgery to check up the post-operative course. Results All patients successfully recovered from surgery procedure,No serious complication, time of cardiopulmonary bypass was 227-331min(mean 290 min),arrest time of ascending aortic was 96-275min (mean 209 min). All patients were discharged form hospital. EBCT indicated smooth blood-stream in prosthesis, reduction of falselumen,no inner-leat and no endo-stent dislocation at 1 month and 3 months after operation. Conclusion "Hybrid technique" (thoratic aortic replacement combined with endoluminal stent grafting) is a safe effective surgical treatment for complex aortic dissection (DeBakey type Ⅰ dissection).