A kind of compound art medium-height trestle system and its using methodTechnical field
The present invention relates to a kind of field of medical technology, particularly to a kind of compound art medium-height trestle system and its userMethod.
Background technology
Sustainer I type interlayer or aorta ascendens and aortic arch aneurysm are still that department of cardiovascular surgery field is the most complicated at presentOne of and risk highest disease.The death rate of sustainer I type interlayer is high, in morbidity beginning to the end 48 hours, often increasesPlus 1 hour death rate increases by 1%, without operative treatment, then the death rate of 3 months is up to 99%.Aorta ascendens and the arch of aortaOnce portion's aneurysm Rupture haemorrhag death rate is also close to 100%.Process at present such disease standard method be grandson's krimer operation (i.e.Aortic root+bow portion artificial vessel replacement+descending aorta trunk Stent).
Deep Hypothermia Circulatory Arrest is needed to carry out putting of aortic arch blood vessel during dissection of aorta I type patient's row grandson's krimer operation at presentChange and descending aorta in the inserting of trunk stented vessel, this grandson's krimer operation time is long, has high demands to dissecting and coincideing, deep in additionHypothermia circulatory arrest affects greatly on the clotting mechanism of patient, and postoperative patient is how dead because of the oozing of blood of Anastomotic bleeding or the surface of a wound.Therefore such as it is avoided that Deep Hypothermia Circulatory Arrest, reduce operating time and dissection and identical difficulty, the death rate of operation will be greatly reduced.
Content of the invention
One of the technical problem to be solved in the present invention, is to provide a kind of compound art medium-height trestle system, employing can coincideThe left subclavian artery overlay film frame blood vessel+ball of artificial blood vessel+line traffic control release expands formula descending aorta overlay film frame artificial blood vessel'sIntegrated design, improves the success rate of complicated operation on aorta with a kind of product of compound support.
One of technical problem of the present invention is realized in：A kind of compound art medium-height trestle system, including can coincideArtificial blood vessel, the left subclavian artery overlay film frame blood vessel of line traffic control release and ball expand the artificial blood of formula descending aorta overlay film framePipe；Described artificial blood vessel expands formula descending aorta overlay film frame artificial blood vessel with described ball and is connected, described left subclavian artery overlay filmStented vessel is located at artificial blood vessel and ball expands the junction of formula descending aorta overlay film frame artificial blood vessel, and left subclavian artery coversMembrane support blood vessel expands formula descending aorta overlay film frame artificial blood vessel with artificial blood vessel and described ball and communicates；Described ball expands formula fall activelySacculus is carried in arteries and veins overlay film frame artificial blood vessel.
Further, described artificial blood vessel, left subclavian artery overlay film frame blood vessel, ball expand formula descending aorta overlay film frameArtificial blood vessel is integrally formed.
Further, described artificial blood vessel is located at the end of mounting system, described left subclavian artery overlay film frame blood vesselPositioned at the middle part of mounting system, described ball expands the postmedian that formula descending aorta overlay film frame artificial blood vessel is located at mounting system.
The two of the technical problem to be solved in the present invention, are to provide a kind of using method of compound art medium-height trestle system,Can avoid by the way of Deep Hypothermia Circulatory Arrest when carrying out aorta ascendens and bow portion vascular replacement art, when shortening operationBetween, reduce the impact to patients Wits for the Deep Hypothermia Circulatory Arrest, reduce vascular anatomy and identical difficulty, improve the one-tenth of operationPower.
The two of the technical problem of the present invention are realized in：A kind of using method of compound art medium-height trestle system, instituteState using method to comprise the steps：
The right upper arm that dissociates at step 10, the free patient's bilateral femoral arterial of dissection, the free left brachial artery of left ancon, right upper arm movesArteries and veins；The free truncus brachiocephalicus of chest and LCC cuff are opened in center；
Step 20, the conduit path through left brachial artery to femoral artery for the foundation；
Step 30, through homonymy femoral artery send into first seal wire reach aortic root, along femoral artery conduit path send intoThe guiding wire of described compound art medium-height trestle system, compound art medium-height trestle system body enters along the first seal wire, compoundArt medium-height trestle system is advanced, and conduit is dropped back, until compound art medium-height trestle system headend reaches aortic arch, guiding wire warpLeft brachial artery stretches out in vitro；
Step 40, through offside femoral artery insert aortic perfusion pipe, insert another aortic perfusion pipe through right arteria brachialis；
Step 50, total body hypothermia to low hypothermia, clamping of aorta, aortic root or cut aorta ascendens perfusion and stop jumpingLiquid；
Step 60, blocking-up pincers block truncus brachiocephalicus and LCC, right arteria brachialis intrusion pipe low discharge brain perfusion respectively；
Retreat compound art medium-height trestle system epitheca under step 70, x-ray fluoroscopy, pull out left brachial artery seal wire, discharge line traffic controlLeft subclavian artery overlay film frame blood vessel so as to enter left subclavian artery fully opening；Ball expands formula descending aorta overlay filmIn the sacculus of stent-graft, injection contrast preparation makes ball expand formula descending aorta overlay film frame artificial blood vessel and fully opens adherent, guarantorHolding capsule expansion state, and fixing balloon distal conduit；
Step 80, through offside femoral artery infusion, keep sacculus with blood perfusion in remote sustainer；
Step 90, remove blocking-up pincers, cut and rise main and aortic arch, in two branch's artificial blood vessel's far-ends and compound artThe artificial blood vessel's row end to end anastomosis coincideing of mounting system proximal part, branch vessel respectively with LCC, truncus brachiocephalicus bloodPipe end to end anastomosis；
Step 100, pumpback sacculus interimage agent, are vented and withdraw sacculus, recover bow portion and above Ink vessel transfusing blood perfusion；
Step 110, process aortic root, artificial aorta ascendens distal vessels and two branch's artificial blood vessel's proximal part end endsIt coincide, complete to rebuild sustainer.
Further, also include between described step 10 and step 20：Step 11, puncture side femoral artery, send into secondSeal wire and Multifunctional catheter, super choosing reaches left ancon arteria brachialis after entering left subclavian artery, cuts left brachial artery and takes out secondSeal wire；
Step 12, exit Multifunctional catheter through opposite side femoral artery, send into long section Multifunctional catheter along left brachial artery seal wireTo femoral artery, and prominent femoral artery.
Further, described low hypothermia is 32～35 DEG C.
Further, described first seal wire is ultrahard guide wire.
Further, described second seal wire is 260cm loach seal wire.
It is an advantage of the current invention that：Left subclavian artery overlay film frame blood using the artificial blood vessel that can coincide+line traffic control releasePipe+ball expands the integrated design of formula descending aorta overlay film frame artificial blood vessel, can carry out aorta ascendens and bow portion blood vesselAvoid during displacement technique, by the way of Deep Hypothermia Circulatory Arrest, shortening operating time, reduce Deep Hypothermia Circulatory Arrest to patient's blood coagulation work(The impact of energy, reduces vascular anatomy and identical difficulty, improves the success rate of operation.
Brief description
The present invention is further illustrated in conjunction with the embodiments with reference to the accompanying drawings.
Fig. 1 is the structural representation of the present invention.
Fig. 2 is the use state schematic diagram of the present invention.
Specific embodiment
Refer to shown in Fig. 1 and Fig. 2, a kind of compound art medium-height trestle system, including the artificial blood vessel 1 that can coincide, line traffic controlThe left subclavian artery overlay film frame blood vessel 2 of release and ball expand formula descending aorta overlay film frame artificial blood vessel 3；Described artificial bloodPipe 1 and described ball expand formula descending aorta overlay film frame artificial blood vessel 3 and are connected, described left subclavian artery overlay film frame blood vessel 2Expand the junction of formula descending aorta overlay film frame artificial blood vessel 3 in artificial blood vessel 1 with ball, and left subclavian artery overlay film frame bloodPipe 2 expands formula descending aorta overlay film frame artificial blood vessel 3 with artificial blood vessel 1 and described ball and communicates；Described ball expands formula descending aorta and coversSacculus 31 is carried in membrane support artificial blood vessel 3.
In the present invention, described artificial blood vessel 1, left subclavian artery overlay film frame blood vessel 2, ball expand formula descending aorta overlay filmStent-graft 3 is integrally formed.
Described artificial blood vessel is located at the end of mounting system, and described left subclavian artery overlay film frame blood vessel is located at carriage supportThe middle part of system, described ball expands the postmedian that formula descending aorta overlay film frame artificial blood vessel is located at mounting system.
Refer to shown in Fig. 2, the using method of a kind of compound art medium-height trestle system of the present invention, described using method bagInclude following steps：
The right upper arm that dissociates at step 10, the free patient's bilateral femoral arterial of dissection, the free left brachial artery of left ancon, right upper arm movesArteries and veins；The free truncus brachiocephalicus of chest and LCC cuff are opened in center；
Step 11, puncture side femoral artery, send into the second seal wire and Multifunctional catheter, after surpassing choosing entrance left subclavian arteryReach left ancon arteria brachialis, cut left brachial artery and take out the second seal wire；
Step 12, exit Multifunctional catheter through opposite side femoral artery, send into long section Multifunctional catheter along left brachial artery seal wireTo femoral artery, and prominent femoral artery.
Step 20, the conduit path through left brachial artery to femoral artery for the foundation；
Step 30, through homonymy femoral artery send into first seal wire reach aortic root, along femoral artery conduit path send intoThe guiding wire 4 of described compound art medium-height trestle system, compound art medium-height trestle system body enters along the first seal wire, compoundArt medium-height trestle system is advanced, and conduit is dropped back, until compound art medium-height trestle system headend reaches aortic arch, guiding wire warpLeft brachial artery stretches out in vitro；
Step 40, through offside femoral artery insert aortic perfusion pipe, insert another aortic perfusion pipe through right arteria brachialis；
, to low hypothermia, described low hypothermia is 32～35 DEG C for step 50, total body hypothermia.Clamping of aorta, aortic rootOr incision aorta ascendens perfusion stops jumping liquid；
Step 60, blocking-up pincers block truncus brachiocephalicus and LCC, right arteria brachialis intrusion pipe low discharge brain perfusion respectively；
Retreat compound art medium-height trestle system epitheca under step 70, x-ray fluoroscopy, pull out left brachial artery seal wire, discharge line traffic controlLeft subclavian artery overlay film frame blood vessel 2 so as to enter left subclavian artery fully opening；Ball expands formula descending aorta overlay filmIn the sacculus 31 of stent-graft 3, injection contrast preparation makes ball expand formula descending aorta overlay film frame artificial blood vessel 3 and fully opens patchWall, keeps balloon expandable state, and fixing sacculus 31 distal catheter；
Step 80, through offside femoral artery infusion, keep sacculus with blood perfusion in remote sustainer；
Step 90, remove blocking-up pincers, cut and rise main and aortic arch, in two branch's artificial blood vessel's far-ends and compound artThe artificial blood vessel 1 row end to end anastomosis coincideing of mounting system proximal part, branch vessel respectively with LCC, truncus brachiocephalicus bloodPipe end to end anastomosis；
Step 100, pumpback sacculus interimage agent, are vented and withdraw sacculus, recover bow portion and above Ink vessel transfusing blood perfusion；
Step 110, process aortic root (Bentall art, David art, Cabrol art etc.), artificial aorta ascendens far-endBlood vessel and two branch artificial blood vessel proximal part end to end anastomosis, complete to rebuild sustainer.
In the present invention, described first seal wire is ultrahard guide wire.So can preferably compound art medium-height trestle system be plantedEnter in human body, described second seal wire is 260cm loach seal wire.
In a word, invention can avoid adopting profound hypothermia when carrying out aorta ascendens and bow portion vascular replacement artStop circulate mode, shorten operating time, reduce the impact to patients Wits for the Deep Hypothermia Circulatory Arrest, reduce vascular anatomy andIdentical difficulty, improves the success rate of operation.
Although the foregoing describing the specific embodiment of the present invention, those familiar with the art should manageSolution, we are merely exemplary described specific embodiment, rather than for the restriction to the scope of the present invention, are familiar with thisEquivalent modification and change that the technical staff in field is made in the spirit according to the present invention, all should cover the present invention'sIn scope of the claimed protection.