吴文辉,黄连军,薛玉国,蒲俊舟,黄小勇,濮欣,刘光锐

• 1:首都医科大学附属北京安贞医院介入诊疗科北京市心肺血管疾病研究所

摘要(Abstract)：

目的探讨主动脉缩窄(CoA)合并症及CoA外科术后并发症介入治疗的可行性。方法2009年6月至2016年12月北京安贞医院6例Co A合并急性主动脉综合征或CoA外科术后并发假性动脉瘤患者接受介入治疗。男5例,女1例;年龄44～56(50.3±5.01)岁。患者术前均经主动脉CT血管造影(CTA)确诊。根据患者主动脉解剖及病理生理特点制定介入治疗方案,4例患者(2例主动脉缩窄合并B型主动脉夹层,1例主动脉缩窄合并穿通性溃疡,1例外科术后缩窄复发合并假性动脉瘤),行胸主动脉腔内修复术(TEVAR)治疗;1例患者Co A外科术后吻合处假性动脉瘤形成采用TEVAR,并对外科姑息的缩窄进行栓塞;1例CoA合并B型主动脉夹层,外科先行升主动脉至降主动脉人工血管转流,再对缩窄处进行封堵。结果介入治疗技术成功率100%。围术期无并发症发生。随访10～60个月,无主动脉相关死亡和再次介入或外科手术干预治疗。结论解剖条件合适的Co A合并症或Co A外科术后并发假性动脉瘤患者可首先尝试TEVAR治疗。解剖条件不合适的Co A合并B型主动脉夹层患者可行复合手术。此类患者应根据解剖及病理生理特点个体化选择手术方式及介入器材。

关键词(KeyWords)： 主动脉缩窄;合并症;心血管外科手术;介入治疗

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81570421)

作者(Author): 吴文辉,黄连军,薛玉国,蒲俊舟,黄小勇,濮欣,刘光锐

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