Aortic Arch Advancement and Ascending Sliding Arch Aortoplasty for Repair of Complex Primary and Recurrent Aortic Arch Obstruction.
Aortic Arch Advancement and Ascending Sliding Arch Aortoplasty for Repair of Complex Primary and Recurrent Aortic Arch Obstruction.
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DOI：
10.1053/j.pcsu.2016.09.007
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发表时间：
2017-01-01
期刊：
影响因子：
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通讯作者：
McKenzie, E Dean
中科院分区：
文献类型：
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作者：
De Leon, Luis E;McKenzie, E Dean
对于患有复杂性主动脉缩窄及主动脉弓发育不良的患者，最佳治疗方法存在争议。接受梗阻性弓部病变修复的儿童存在终生复发的风险。已有多种技术用于处理复杂性原发性和复发性主动脉缩窄。我们在德克萨斯儿童医院（得克萨斯州休斯敦）采用的方法是通过正中胸骨切开术，在体外循环下，运用主动脉弓前移和升主动脉滑动弓部成形术等技术，以解剖学方式处理这些病变。对复杂性原发性或复发性主动脉梗阻进行解剖学修复是安全的，修复效果良好，复发率低。这两种手术均利用自身主动脉组织恢复正常的弓部轮廓。采用何种具体手术策略取决于患者的年龄、解剖结构以及组织的弹性。
The optimal treatment of patients with complex coarctation of the aorta and hypoplastic aortic arch is controversial. Children undergoing repair of obstructive arch lesions are at lifelong risk of recurrence. Multiple techniques have been described to address complex primary and recurrent coarctation. Our approach at Texas Children's Hospital (Houston, TX) has been to address these lesions in an anatomic fashion via median sternotomy, under cardiopulmonary bypass using the techniques of aortic arch advancement and ascending sliding arch aortoplasty. Anatomic repair of complex primary or recurrent aortic obstruction is safe and produces a favorable repair with a low rate of recurrence. Both operations restore normal arch contour using native aortic tissue. The decision of which particular surgical strategy to use depends on the patient's age, anatomy, and the elasticity of the tissue.