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ID:19681790
大小:5.44 MB
页数:11页
时间:2018-10-04
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1、One-stagerepairforStanfordTypeBAorticDissectionconcomitantwithcardiacdiseasesOpenstentedelephanttrunktechniquecombinedwithcardiacoperationLizhongSunM.D.AnzhenHospitalofCapitalMedicalUniversityBeijingAorticDiseaseCentrePatientswithbothtypeBAorticdissectionandcardiacdiseasesBackgroundWhatistheBESTther
2、apeuticstrategy?PatientsandMaterialsTime:Apr.2007——Mar.2010PatiensNumber:16TypeBAoDwithcardiacdiseaseMeanAge:49.75±13.42years(range17-64years)Gender:12male,4femaleMaximalDiameter:5.43±0.88cm(range4.2-7.7cm)Phase:3Acute,13ChronicCardiacdiseases:5AI,4ARA,6AAA,2MI,3AAD1TI,1ASD,2MarfanAI:aorticvalveinsu
3、fficiency;MI:mitralvalveinsufficiency;AAA:ascendingaorticaneurysm;TI:tricuspidvalveinsufficiency;ASD:atrialseptaldefect;AAD:ascendingaorticdilation,ARA:aorticrootaneurysmOperativeTechniquesACPviaRAxAStentedgraftBentallprocedureACP:antegradecerebralperfusion,RAxA:rightaxillarryarteryOperativeTechniqu
4、esAAo:ascendingaorta,LSCA:leftsunclavianartery,LCCA:leftcommoncarotidarteryAAo→LSCAorLSCA→LCCAOperativeTechniquesLSCAwasinvolvedbyaorticdissectionAlternativestrategybeforesurgery3monthsaftersurgery3urgentoperations;13electiveoperationsConcomitantcardiacoperations:4Bentall,2Wheat,2AVR+AAoplasty,4AAor
5、eplacement,1AVR,1AAoplasty,1ASDrepair+TVP+MVP,1MVRAAo:ascendingaorta,AVR:aorticvalvereplacement,ASD:atriumseptaldefect,MVR:mitralvalvereplacement,TVP:tricuspidvalveplasty,MVP:mitralvalveplastyResultsResultsCPBtime(min)131.62±23.85(100-177)aorticcrossclampingtime(min)64.69±9.72(47-78)SACPtime(min)21.
6、94±3.60(17-32)Intubationtime(hours)15.27±3.71(9-20)ICUstay(days)1-2postoperativein-hospitalstay(days)9.69±2.85(7-17)Noperioperativedeaths,NoperioperativecomplicationsDisscussionIndications:complicatedtypeBAoDwithcardiacdiseasescomplicatedtypeBAoDinvolvingdistalarchMarfanpatientsAdvantages:easyforope
7、rating;lessinjuries;one-stagecombinedadvantagesofETandTEVARTechniquecautions:suturingtechniquealternativestrategyResearchlimitations:limitedptsnumberretrospectresearchAoD:aorticdissection,ET:elephantt
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