b型夹层直视支架象鼻手术

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1、One-stagerepairforStanfordTypeBAorticDissectionconcomitantwithcardiacdiseasesOpenstentedelephanttrunktechniquecombinedwithcardiacoperationLizhongSunM.D.AnzhenHospitalofCapitalMedicalUniversityBeijingAorticDiseaseCentrePatientswithbothtypeBAorticdissectionandcardiacdiseasesBackgroundWhatistheBE

2、STtherapeuticstrategy?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:aor

3、ticvalveinsufficiency;MI:mitralvalveinsufficiency;AAA:ascendingaorticaneurysm;TI:tricuspidvalveinsufficiency;ASD:atrialseptaldefect;AAD:ascendingaorticdilation,ARA:aorticrootaneurysmOperativeTechniquesACPviaRAxAStentedgraftBentallprocedureACP:antegradecerebralperfusion,RAxA:rightaxillarryarter

4、yOperativeTechniquesAAo：ascendingaorta，LSCA：leftsunclavianartery，LCCA：leftcommoncarotidarteryAAo→LSCAorLSCA→LCCAOperativeTechniquesLSCAwasinvolvedbyaorticdissectionAlternativestrategybeforesurgery3monthsaftersurgery3urgentoperations；13electiveoperationsConcomitantcardiacoperations:4Bentall，2Wh

5、eat，2AVR+AAoplasty，4AAoreplacement，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.

6、69±9.72(47-78)SACPtime(min)21.94±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：complicatedtypeBAoDwithcardiacdiseasescomplicatedtypeBAoDinvolvingdistalarc

7、hMarfanpatientsAdvantages：easyforoperating;lessinjuries;one-stagecombinedadvantagesofETandTEVARTechniquecautions：suturingtechniquealternativestrategyResearchlimitations：limitedptsnumberretrospectresearchAoD:aorticdissection,ET:elephantt