Subclavian Cannulation Improves Outcome of Surgery for Type a Aortic Dissection
Subclavian Cannulation Improves Outcome of Surgery for Type a Aortic Dissection
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锁骨下插管可改善 a 型主动脉夹层手术的效果
DOI：
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发表时间：
2007
影响因子：
0.7
通讯作者：
T. Pillay
中科院分区：
文献类型：
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作者：
S. M. Nouraei;SA Reza Nouraei;Anand K Sadashiva;T. Pillay
急性A型主动脉夹层是一个重大的紧急情况，继续造成显着的发病率和死亡率。鉴于病变的解剖结构，在心肺转流期间使用不同动脉流入部位实现的不同循环配置可能会影响结果。比较锁骨下动脉插管与股动脉插管的患者。回顾了1999年至2004年间因急性A型主动脉夹层而接受急诊手术的49例连续患者（平均年龄60 ± 14岁）。对临床表现、术前特征、手术细节、住院死亡率和神经系统结局进行分析。29例患者接受股动脉插管，20例患者接受锁骨下动脉插管。两组在术前特征方面具有可比性。平均随访29个月。锁骨下动脉插管在住院死亡（10% vs. 44%）和神经功能缺损方面具有显著优势。锁骨下动脉插管后需要再次手术的患者显著较少。
Acute type A aortic dissection is a major emergency that continues to cause significant morbidity and mortality. Given the anatomy of the lesion, different circulatory configurations achieved during cardiopulmonary bypass using different arterial inflow sites can influence outcome. Patients who had subclavian artery cannulation were compared with those who had femoral artery cannulation. Forty-nine consecutive patients (mean age, 60 ± 14 years) undergoing emergency surgery for acute type A aortic dissection between 1999 and 2004 were reviewed. Data on presentation, preoperative characteristics, operative details, hospital mortality, and neurological outcome were analyzed. Twenty-nine patients had femoral artery cannulation, and 20 had subclavian artery cannulation. The groups were comparable in terms of preoperative characteristics. The mean follow-up was 29 months. Subclavian artery cannulation conferred significant advantages in respect of hospital death (10% vs. 44%) and neurological impairment. Significantly fewer patients required re-operation following subclavian artery cannulation.