Management of the difficult left subclavian artery during aortic arch repair

被引：27

作者：

Hage, Ali ^{[1
]}

Ginty, Olivia ^{[1
]}

Power, Adam ^{[2
]}

Dubois, Luc ^{[2
]}

Dagenais, Francois ^{[3
]}

Appoo, Jehangir J. ^{[4
]}

Bozinovski, John ^{[5
]}

Chu, Michael W. A. ^{[1
]}

机构：

[1] Western Univ, Lawson Hlth Res Inst, Dept Surg, Div Cardiac Surg, London, ON, Canada

[2] Western Univ, Lawson Hlth Res Inst, Dept Surg, Div Vasc Surg, London, ON, Canada

[3] Quebec Heart & Lung Inst, Div Cardiac Surg, Quebec City, PQ, Canada

[4] Univ Calgary, Cumming Sch Med, Libin Cardiovasc Inst, Div Cardiac Surg, Calgary, AB, Canada

[5] Univ British Columbia, Royal Jubilee Hosp, Div Cardiac Surg, Victoria, BC, Canada

来源：

ANNALS OF CARDIOTHORACIC SURGERY | 2018年 / 7卷 / 03期

关键词：

Aortic arch surgery; left subclavian artery (SCA); revascularization; ELEPHANT TRUNK IMPLANTATION; VASCULAR-SURGERY; PRACTICE GUIDELINES; ENDOLUMINAL REPAIR; REPLACEMENT; DISSECTION; TRANSPOSITION; SOCIETY; REVASCULARIZATION; PATHOLOGY;

D O I：

10.21037/acs.2018.03.14

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Management of the left subclavian artery (SCA) during aortic arch surgery is associated with several challenges, including preserving distal perfusion, achieving hemostasis and preventing posterior circulation stroke and spinal cord injury. The most common challenge remains its deep position in the chest, often exacerbated by posterior and apical displacement from an arch aneurysm. We discuss several management options consisting of pre-, intra- and post-operative strategies and their respective advantages, disadvantages and clinical outcomes. A clinical algorithm is proposed to help guide decision-making in managing the difficult left SCA during aortic arch repair.

引用

页码：414 / 421

页数：8

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