2021年 · 第37卷第05期

acute aortic syndrome (AAS) is a group of cardiovascular diseases that seriously threaten human life and health. In recent years, with the popularization of imaging techniques such as multi-slice spiral CT angiography, the diagnosis rate of AAS has increased greatly. At the same time, the development of surgical technique and endovascular repair technique has significantly reduced the mortality and complication rate of AAS surgery.

Modern aortic surgery is a new discipline developed slowly on the basis of predecessors. With the advancement of material science, modern aortic surgery began to develop slowly until Voorhees used artificial blood vessels made of polyethylene fiber plastic in 1952 for abdominal aortic aneurysm resection and replacement treatment, and DeBakey used elastic knitted polyester (dacron) artificial blood vessels in 1958. The representative disease of aortic surgery is aortic dissection, which is represented by the surgical treatment of type A dissection, and full arch replacement is the difficulty. The application of deep hypothermic circulatory arrest technique makes aortic arch replacement possible. With the advancement of materials, surgical techniques and organ protection techniques. The surgical treatment of type A dissection is gradually maturing. The application of the "elephant trunk" technique (insertion of a section of artificial blood vessel into the descending aorta) has promoted the development of total arch replacement. It makes it easy to stop bleeding in the first-stage operation, and lays the foundation for the second-stage thoracic and abdominal aorta replacement. However, the classic "elephant trunk" technique has its weaknesses. When the artificial blood vessel is soft, the patient's descending aorta is thick or thin, or tortuous, the artificial blood vessel is easy to break or narrow. In 2003, Sun Lizhong combined the characteristics of interventional stent and artificial blood vessels to invent an intraoperative stent system, which greatly reduced the difficulty of operation. Total aortic arch replacement + intraoperative stenting of descending aorta has become the standard procedure for the treatment of type A dissection and other diseases involving the arcuate aorta, and has been called "Sun's operation" by colleagues. The emergence of Sun's surgery reduced the difficulty of surgery, obtained good false cavity remodeling effect, and created better conditions for reoperation, and became the standard surgical procedure for surgery involving the aortic arch represented by type A dissection.