{"id":18797,"date":"2020-02-04T16:23:56","date_gmt":"2020-02-04T15:23:56","guid":{"rendered":"https:\/\/devhml.givememore.net\/specialites\/chirurgie-cardiaque-cardiologie-adulte\/les-pathologies\/pathologie-de-laorte\/"},"modified":"2022-05-03T16:47:03","modified_gmt":"2022-05-03T14:47:03","slug":"pathologie-de-laorte","status":"publish","type":"service","link":"https:\/\/devhml.givememore.net\/specialites\/chirurgie-cardiaque\/les-pathologies\/pathologie-de-laorte\/","title":{"rendered":"Pathologie de l\u2019aorte"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Les an\u00e9vrismes ou dilatation de l\u2019aorte constituent une indication op\u00e9ratoire lorsqu\u2019ils exposent au risque de rupture ou de dissection aortique du fait de leur taille ou de leur fragilit\u00e9 et dans certaines maladies du tissu collag\u00e8ne (Marfan, bicuspidie aortique).<\/strong><\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\">\n<p class=\"wp-block-paragraph\">La chirurgie consiste \u00e0 remplacer le segment d\u2019aorte malade par un tube en Dacron. La plupart du temps, il s\u2019agit de l\u2019aorte ascendante. La complexit\u00e9 du geste varie selon le si\u00e8ge et l\u2019\u00e9tendue de l\u2019an\u00e9vrisme. Lorsque l\u2019an\u00e9vrisme d\u00e9bute \u00e0 l\u2019origine de l\u2019aorte d\u00e8s la sortie du c\u0153ur, il englobe la valve aortique et la naissance des art\u00e8res coronaires. L\u2019op\u00e9ration de remplacement de l\u2019aorte ascendante impose donc de r\u00e9implanter les deux art\u00e8res coronaires dans le tube et, pour ce qui est de la valve aortique, soit de la changer (intervention de Bentall), soit de la conserver et, dans ce cas-l\u00e0, de la r\u00e9ins\u00e9rer dans le tube (intervention de Tirone David).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dans des cas plus rares, le remplacement de la crosse aortique s\u2019impose et la technique chirurgicale est encore plus complexe avec r\u00e9implantation des vaisseaux \u00e0 destin\u00e9e c\u00e9r\u00e9brale dans la proth\u00e8se apr\u00e8s avoir effectu\u00e9 une perfusion s\u00e9par\u00e9e des vaisseaux c\u00e9r\u00e9braux et un arr\u00eat circulatoire complet temporaire de la CEC en hypothermie profonde.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Les an\u00e9vrismes de l\u2019aorte descendante et thoraco-abdominal peuvent \u00eatre trait\u00e9s, selon leur localisation et leur \u00e9tendue, soit par un remplacement de l\u2019aorte avec un large abord chirurgical (thoraco-phr\u00e9no-laparotomie) soit par endoproth\u00e8se introduite par les vaisseaux f\u00e9moraux et d\u00e9ploy\u00e9e \u00e0 l\u2019int\u00e9rieur de l\u2019aorte sous radioscopie en salle hybride (au sein de l&rsquo;H\u00f4pital Marie-Lannelongue).<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-image\"><figure class=\"alignright is-resized\"><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/devhml.givememore.net\/wp-content\/uploads\/2020\/02\/Intervention-de-Tirone-David-1024x817.jpg\" alt=\"\" class=\"wp-image-19393\" width=\"429\" height=\"373\"\/><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright is-resized\"><img decoding=\"async\" src=\"https:\/\/devhml.givememore.net\/wp-content\/uploads\/2020\/02\/Bentall-m\u00e9canique-1024x768.jpg\" alt=\"\" class=\"wp-image-19389\" width=\"425\" height=\"346\"\/><\/figure><\/div>\n<\/div>\n<\/div>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"chiffres-cles\">Chiffres cl\u00e9s<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Plus de 100 patients op\u00e9r\u00e9s chaque ann\u00e9e pour une chirurgie concernant l\u2019aorte elle-m\u00eame.<br>Environ 20 patients b\u00e9n\u00e9ficient d\u2019une chirurgie de type Bentall,<br>Environ 20 patients b\u00e9n\u00e9ficient d\u2019une chirurgie de type Tirone David,<br>Environ 15 patients op\u00e9r\u00e9s en grande urgence de dissection aortique.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les an\u00e9vrismes ou dilatation de l\u2019aorte constituent une indication op\u00e9ratoire lorsqu\u2019ils exposent au risque de rupture ou de dissection aortique du fait de leur taille ou de leur fragilit\u00e9 et dans certaines maladies du tissu collag\u00e8ne (Marfan, bicuspidie aortique). La chirurgie consiste \u00e0 remplacer le segment d\u2019aorte malade par un tube en Dacron. La plupart [&hellip;]<\/p>\n","protected":false},"author":22,"featured_media":0,"parent":18793,"menu_order":3,"template":"","meta":{"_acf_changed":false,"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"etablissements":[],"services":[],"class_list":["post-18797","service","type-service","status-publish","hentry"],"acf":[],"featured_img":false,"coauthors":[],"author_meta":{"author_link":"https:\/\/devhml.givememore.net\/author\/charlotte-gmm\/","display_name":"Charlotte"},"relative_dates":{"created":"Publi\u00e9 6 ans il y a","modified":"Mis \u00e0 jour 4 ans il y a"},"absolute_dates":{"created":"Publi\u00e9 le 4 f\u00e9vrier 2020","modified":"Mise \u00e0 jour le 3 mai 2022"},"absolute_dates_time":{"created":"Publi\u00e9 le 4 f\u00e9vrier 2020 16 h 23 min","modified":"Mise \u00e0 jour le 3 mai 2022 16 h 47 min"},"featured_img_caption":"","tax_additional":{"etablissements":{"linked":[],"unlinked":[],"slug":"etablissements","name":"\u00c9tablissements"},"services":{"linked":[],"unlinked":[],"slug":"services","name":"Services"}},"series_order":"","_links":{"self":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/18797","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service"}],"about":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/types\/service"}],"version-history":[{"count":3,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/18797\/revisions"}],"predecessor-version":[{"id":23380,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/18797\/revisions\/23380"}],"up":[{"embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/service\/18793"}],"wp:attachment":[{"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/media?parent=18797"}],"wp:term":[{"taxonomy":"etablissements","embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/etablissements?post=18797"},{"taxonomy":"services","embeddable":true,"href":"https:\/\/devhml.givememore.net\/api\/wp\/v2\/services?post=18797"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}