Objective:To investigate the effectiveness and feasibility of 3D printing-assisted extracorporeal fenestration techniques in thoracic aortic endoluminal repair.Methods:Retrospectively analyzed the clinical data of patients who underwent endovenous repair of the thoracic aorta with the application of 3D printing technology-assisted extracorporeal windowing in the Department of Cardiovascular Surgery, Wuhan University Hospital from January 2019 to May 2021, and analyzed the surgical results as well as the occurrence of perioperative complications.Results:A total of 10 patients with a mean age of(53.3±15.7) years were included, including 4 cases of complex B aortic coarctation, 5 cases of thoracic aortic aneurysm and 1 case of abdominal aortic aneurysm. All patients in this group underwent endoluminal repair of the thoracic aorta with 3D printing assisted extracorporeal fenestration, including 1 case of PCI performed at the same time. There were no postoperative complications and no perioperative deaths.Conclusion:3D printing technology assisted extracorporeal fenestration and endoluminal aortic repair can accurately position aortic stents for fenestration, optimise endoluminal treatment options and improve patient prognosis.

主动脉夹层起病凶险,进展迅速,发病早期自然死亡率极高.传统开放手术方式治疗主动脉夹层,效果明确,但创伤巨大,围术期并发症发生率较高.近些年胸主动脉腔内修复术(TEVAR)广泛用于主动脉夹层的治疗,手术创伤及围术期病死率明显下降[1].但部分复杂病例的TEVAR,比如部位复杂(累及主动脉弓及弓上分支)和形态学复杂(短瘤颈、弓型不佳、迷走锁骨下、右弓右降),正确认识主动脉夹层的真假腔、观察患者的血流动力学变化、找到支架开窗位置仍存在一定挑战.随着医疗技术的发展,通过MRI,CT影像进行3D打印物理建模用于术前模拟演练可以明显提高TEVAR成功率[2].如何在未来更好地利用和发展该项技术已经成为热门研究方向.