Repair of traumatic aorto-caval fistula

Chest penetrating injury can occasionally cause aortic and vena cava traffic caused by ascending aorta and superior vena cava. The prognosis varies depending on the size of the fistula. A large number of left-to-right shunts occur locally, and the superior vena cava pressure increases sharply. The amount of blood increased significantly. This is followed by an increase in central venous pressure, jugular vein engorgement, and progressive cardiac insufficiency. Thoracic auscultation can hear continuous murmurs at the shunt site, and two-dimensional echocardiography, color Doppler, and retrograde aortic angiography can determine the diagnosis and shunt site. Right heart catheterization can understand hemodynamic changes. Curing disease: Indication The diagnosis of aortic-cavity fistula is established, and the repair of traumatic aortic-cavity fistula is the only reasonable treatment. Preoperative preparation Actively doing cardiac diuretic treatment, limiting sodium intake, controlling heart failure and improving heart rate are necessary preparations for elective surgery. Surgical procedure 1. The chest is in the middle of the incision. Through the femoral artery cannulation, the obstruction band of the ascending aorta obstruction forceps and the superior vena cava cannula should be placed distal to the fistula to establish extracorporeal circulation. 2. Exploring the aortic-superior vena cava under complete bypass of cardiopulmonary bypass and cardiac arrest. 3. Apply autologous pericardial or artificial fabric to repair the fistula of the artery and vein. 4, old gargle, can be cut longitudinally ascending aortic anterior wall, revealing the fistula from the aortic cavity, using artificial fabric for repair. 5, after the mouthwash repair completely stop bleeding, gradually stop the extracorporeal circulation, and routinely close the chest. Traumatic aorta-pulmonary spasm is occasionally encountered, with clinical manifestations and surgical treatment of the main-pulmonary septal defect.

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