从事心血管外科临床工作10余年，2005年晋升副主任医师，目前担任外科13病区医疗组长，主刀完成各类心血管外科手术1000余台。发表论文20余篇，其中6篇SCI收录论文。获 科技进步二等奖一项，北京市科学技术奖二等奖一项，中华医学科学技术一等奖一项。2008年获得硕士研究生导师资格。目前除开展常规正中开胸先心病矫治及瓣膜置换手术外，还开展侧切口入路简单先心病手术。 ???????????????本书涵盖了20余种常规开胸和胸骨上段微创切口主动脉外科手术。包括在 上率先开展的急性A型夹层行微创切口孙氏手术等。改良的弓部分支动脉优先吻合和全脑灌注方式，解决了全弓替换手术中脑保护这一核心问题，避免了传统的深低温停循环，降低了手术风险。这些手术技术不同于 ?同行开展的同类手术方式，是孙氏手术的继承和发扬。 本书内视频由解放军总医院制作。适合心血管外科医生、主治医师、研究生培训使用，对本学科 专业人员进一步提高手术技能、开展新业务有很好的参考价值。 ???????????????\\\" 部分?常用技巧 章临床实践的总体原则 ··················································································3第二章主动脉吻合口后壁强化吻合技术 ···································································4第三章主动脉吻合口包裹技术 ···············································································6第四章结扎切断无名静脉 ·····················································································8第五章动脉插管部位 ························································································· 10第六章升主动脉远端或半弓吻合人工血管远端剪成斜面 ············································ 14第七章用力牵拉人工血管以测量长度 ···································································· 16第八章人工血管大小的选择 ················································································ 17第九章缩小人工血管口径的方法：“飞镖”样裁剪 ·················································· 18第十章增加人工血管口径的方法 ·········································································· 20第十一章切除主动脉不要距离阻断钳太近 ································································· 21第十二章充分游离主动脉后壁 ················································································ 22第十三章心包腔内充满二氧化碳 ············································································· 24第十四章拉紧吻合口缝线 ······················································································ 26第十五章吻合口缝线松弛的处理 ············································································· 27第十六章向下牵拉静脉管道以改善主动脉根部显露 ····················································· 29第十七章应用“Valerie”缝线显露主动脉根部 ···························································· 30第十八章环绕升主动脉套带：不要损伤肺动脉 ··························································· 31第十九章胸骨延迟闭合的心包桥接 ·········································································· 33第二十章再次开胸“胸骨后放置纱布”技术 ······························································ 35第二十一章 胸骨强化闭合技术 ··················································································· 37第二十二章 再次开胸出血巾钳控制技术 ······································································· 39第二十三章 升主动脉吻合近完成时，停止左心室引流，进行排气 ······································ 41第二十四章 深低温停循环的实施 ················································································ 42第二十五章 在左锁骨下动脉近端阻断 ·········································································· 45第二十六章 尽早恢复左锁骨下动脉血供 ······································································· 46第二十七章 其他脑灌注策略 ······················································································ 48第二十八章 术中灌注不良事件 ··················································································· 51第二十九章 在慢性主动脉夹层中不要消除假腔 ······························································ 54第三十章在不影响无名动脉血流的前提下紧靠无名动脉放置阻断钳 ································ 55第三十一章 左下肺静脉插管用于左心房_股动脉转流 ······················································ 56第三十二章 心房颤动患者的左心房插管 ······································································· 58第三十三章 John法则：在未钳夹主动脉的情况下，切勿开始左心房_股动脉转流 ··················· 59第三十四章 经肺动脉进行静脉回流 ············································································· 61第三十五章 离降主动脉和食管 ················································································ 62第三十六章 对于巨大主动脉应用Siena人工血管 ······························································ 63第三十七章 腔内吻合技术 ························································································· 66第三十八章 外膜下血肿 ···························································································· 68第三十九章 在人工血管之间的吻合口应用生物胶 ··························································· 69第四十章创造性地进行人工血管之间的吻合（升主动脉人工血管与弓部人工血管的连接）····· 70第四十一章 肺粘连的处理 ························································································· 72第四十二章 主动脉瘤与胸壁粘连的处理 ······································································· 73第四十三章 再次心脏手术：有限的游离方式 ································································· 75第四十四章 取出原先植入的人工瓣膜 ·········································································· 77第四十五章 取出放置失败的介入覆膜支架 ···································································· 79第四十六章 充盈人工血管 ························································································· 81第二部分?升主动脉及主动脉弓第四十七章 主动脉形态决定切除范围 ·········································································· 85第四十八章 充分利用交界处的三角部位 ······································································· 87第四十九章 主动脉瓣修复术 ······················································································ 88第五十章主动脉瓣置换术 ······················································································ 94第五十一章 升主动脉置换术无冠窦位置的 深缝合 ························································ 97第五十二章 带瓣管道主动脉根部置换术：Bentall手术 ······················································ 98第五十三章 “V”形切除主动脉根部重塑 ····································································109第五十四章 保留主动脉瓣的根部置换 ········································································· 111第五十五章 弓部置换选项（3支血管“岛”状吻合、2支血管“岛”状吻合、3个分支血管单独吻合） ··························································································· 118第五十六章 主动脉弓的分支动脉瘤 ············································································121第五十七章 标准（非冷冻）象鼻手术 ·········································································123第五十八章 找回象鼻血管：3种选择 ···········································································125第五十九章 单独的象鼻手术 ·····················································································127第六十章急性A型主动脉夹层 ················································································129第六十一章 Ross手术 ·······························································································139第三部分?降主动脉和胸腹主动脉第六十二章 降主动脉和胸腹主动脉置换术 ···································································153第六十三章 急性B型主动脉夹层：临床视角及外科手术 ··················································159第六十四章 开窗手术 ······························································································164第六十五章 胸腹主动脉置换术 ··················································································170第六十六章 降主动脉胸腹主动脉置换术后监护 ·······················································