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find Keyword "胸主动脉" 27 results
  • 胸主动脉真性动脉瘤的外科治疗

    目的 总结胸主动脉真性动脉瘤的外科治疗经验。 方法 回顾性分析2007年7月至2009年8月云南省心血管病医院采用Bentall手术治疗25例胸主动脉瘤患者的临床资料,其中男16例,女9例;年龄26~65岁。单纯主动脉根部瘤9例,主动脉根部瘤合并升主动脉瘤6例,主动脉根部瘤合并升主动脉瘤累及主动脉弓10例。 结果 无手术死亡。术后发生并发症 12 例,包括心律失常、出现神经系统症状和二次开胸止血等,均经相应的治疗治愈。围术期无心肌梗死发生。随访24例,失访1例。随访时间 6个月~1.5年,随访期间因心律失常死亡1例。术后6个月所有随访患者行64排双源螺旋CT复查显示:冠状动脉吻合口未见狭窄。 结论 采用外科手术治疗胸主动脉真性动脉瘤效果确切。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • Spinal Cord Protection During Aortic Operation

    Spinal cord injury is one of severe complications after thoracic aortic surgery. The degree and time of spinal cord ischemia during surgery, reconstruction of the blood supply of spinal cord ,biochemistry factors ,ischemiareperfusion injury, etc. are considered as factors influence on the complication of spinal cord after surgery. At present, to improve the surgical technique, to increase the blood supply of spinal cord, such as the mechanical dynamic blood perfusion, arterial shunt and cerebrospinal fluid shunt, to degrade the metabolic rate of spinal cord using hypothermia, and to prevent the ischemia-reperfusion injury using drugs are the methods for spinal cord protection during the aortic surgery. The feature of blood circulation of spinal cord, mechanisms of spinal cord injury and the latest progress of spinal cord protection is reviewed in this article.

    Release date:2016-08-30 06:18 Export PDF Favorites Scan
  • 胸主动脉夹层的再次手术治疗

    目的分析胸主动脉夹层术后复发的原因,总结其外科治疗经验。方法回顾分析4例主动脉夹层术后复发患者行手术治疗的临床资料,其中行Bentall手术2例,胸主动脉置换术2例。结果全组无手术死亡,术后并发呼吸及肾功能不全1例,声音嘶哑1例。结论胸主动脉夹层术后再发与原发病、血压控制不良、第1次手术适应证的选择有关,急性DeBakeyI、II型患者应行急诊手术治疗。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 胸主动脉瘤的外科治疗

    目的 总结 19例胸主动脉瘤患者的外科治疗经验。 方法  19例胸主动脉瘤患者 ,其中升主动脉瘤 9例 (马方综合征 8例 ) ,7例行 Bentall手术 ,2例行 Cabrol手术 ;降主动脉瘤 10例 ,均行降主动脉置换术。 结果 除 1例患者术中死亡外 ,其余患者经超声心动图检查均示主动脉瓣关闭良好 ,移植的冠状动脉、降主动脉通畅 ,无扭曲 ,无脊髓损伤和神经系统并发症。随访 18例 ,随访时间 0 .3~ 5 .4年 ,心功能恢复至 级 3例 , 级 15例 ,效果满意。 结论 手术治疗胸主动脉瘤安全有效。

    Release date:2016-08-30 06:28 Export PDF Favorites Scan
  • 胸主动脉瘤及主动脉夹层外科治疗进展

    胸主动脉瘤及主动脉夹层病情凶险,死亡率和病残率均很高.近几年在保留和不保留主动脉瓣的主动脉根重建术治疗升主动脉瘤,弓部主动脉瘤切除与脑保护,胸主动脉瘤或胸腹主动脉瘤切除与脊髓保护,以及主动脉腔内支架移植术等方面取得了较大的进展.手术死亡率已从31.4%下降至3.3%~4.8%.胸主动脉瘤,特别是主动脉夹层系一全身性主动脉病变,近年来手术疗效有所改善,但远期复发率和再手术率仍较高.主动脉内支架移植与外科手术结合应用,对复杂的伴有降主动脉病变的A型主动脉夹层治疗,可能是一种安全而有效的方法.

    Release date:2016-08-30 06:30 Export PDF Favorites Scan
  • Hybrid Procedures in Treatment for Aortic Arch Lesions: Short- and Long-Term Results

    ObjectiveTo evaluate the short-and long-term results of hybrid procedures in the treatment for aortic arch lesions. MethodsFrom October 2002 to March 2011, 28 patients with thoracic aortic aneurysms or dissections involving the aortic arch were treated with hybrid endovascular treatment in our center. Twenty-two males and 6 females were in the series. The mean age of the patients was 68 years old. Of 28 patients, 15 were atherosclerotic thoracic aortic aneurysms and 13 were thoracic aortic dissection. Follow-up protocol consisted of computed tomography (CT) angiograms or ultrasound was performed in 3, 6, and 12 months, and annually thereafter. The main goal was to evaluate the operative mortality, morbidity, and the longterm survival of these patients. ResultsHybrid procedures included 12 totalarch transpositions, 3 left common carotid artery (LCCA)left subclavian artery (LSA) bypass, 11 right common carotid artery (RCCA)LCCA-LSA bypass, 2 RCCA-LCCA bypass. The technical success rate was 92.9% (26/28). The complications occurred in 10 patients (35.7%). Operative mortality was 7.1% (2/28). The apoplexia rate was 7.1% (2/28). The time of followup was (36±3) months. The patency rates of 1-year, 3-year, and 5-year were 100%, 92.9% (26/28), and 85.7% (24/28), respectively. The survival rates of 1-year, 3-year, and 5-year were 89.3% (25/28), 71.4% (20/28), and 60.7% (17/28), respectively. ConclusionsThe short-and long-term results with hybrid procedures in the treatment for aortic arch diseases are satisfactory. Further reducing the complications is the key to increase the survival rate.

    Release date:2016-09-08 10:45 Export PDF Favorites Scan
  • EFFECTIVENESS EVALUATION OF THORACIC ENDOVASCULAR AORTIC REPAIR FOR BLUNT THORACIC AORTIC INJURY WITH HOSTILE STENT-GRAFT PROXIMAL LANDING ZONE

    ObjectiveTo explore the effectiveness of thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injury (BTAI) with hostile stent-graft proximal landing zone. MethodsA retrospective analysis was made on the clinical data of 13 patients with BTAI with hostile stent-graft proximal landing zone treated by TEVAR between December 2007 and December 2014. There were 10 males and 3 females with the mean age of 44 years (range, 24-64 years). The imaging examination indicated Stanford type B aortic dissection in 7 cases, pseudoaneurysm in 3 cases, aneurysm in 1 case, and penetrating ulcer in 2 cases. According to the partition method of thoracic aortic lesion by Mitchell, 8 cases underwent stent-graft with left subclavian artery (LSA) coverage, 3 underwent chimney stents for LSA, and 2 for left common carotid artery (LCCA). In 2 cases receiving chimney TEVAR involving LCCA, one underwent steel coils at the proximal segment of LSA to avoid type II endoleak and the other underwent in situ fenestration for endovascular reconstruction of LSA. ResultsAll TEVAR procedures were successfully performed. The mean operation time was 1.8 hours (range, 1-3 hours); the mean intraoperative blood loss was 120 mL (range, 30-200 mL); and the mean hospitalization time was 15 days (range, 7-37 days). No perioperative death and paraplegia occurred. The patients were followed up 3-30 months (mean, 18 months). Type I endoleak occurred in 1 case during operation and spontaneously healed within 6 months. Hematoma at brachial puncture site with median nerve compression symptoms occurred in 1 case at 3 weeks after operation; ultrasound examination showed brachial artery pseudoaneurysm and thrombosis, and satisfactory recovery was obtained after pseudoaneurysmectomy. No obvious chest pain, shortness of breath, left upper limbs weakness, numbness, and dizziness symptoms were observed. Imaging examination revealed that stentgraft and branched stent remained in stable condition. Meanwhile the blood flow was unobstructed. No lesions expanded and ruptured. No new death, bacterial infection, or other serious complications occurred. ConclusionAccording to Mitchell method, individualized plan may be the key to a promising result. More patients and further follow-up need to be included, studied, and observed.

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  • 对腔内修复Stanford B型主动脉夹层手术范围的质疑——应将“远端旷置”改为“全程修复”

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  • Surgical Treatment of Bicuspid Aortic Valve Combined with Toracic Aortic Dilation

    ObjectiveTo analyze the clinical characteristics and surgical treatment of bicuspid aortic valve combined with thoracic aortic dilation. MethodsWe retrospectively analyzed the clinical data of 68 patients of bicuspid aortic valve combined with thoracic aortic dilation underwent surgical treatment in our hospital between January 2010 and June 2014. There were 47 males and 21 females at age of 26-77(44.5±16.3) years. Different surgical treatments including Wheat procedure(n=22), aortic valve replacement+ascending aortoplasty(n=10), Bentall procedure(n=13), aortic valve replacement+ascending aortic replacement+right hemi aortic arch replacement(n=13), Bentall procedure+ascending aortic replacement+right hemi aortic arch replacement(n=8), Bentall procedure+ascending aortic replacement+total arch replacement+stented elephant trunk(n=2) were carried out according to the type. ResultsAll 68 patients underwent surgical treatment. The mortality in hospital is at 4.4%(3/68). The postoperative complications were neurological and mental complications(n=3), pneumonia(n=2), and exploratory thoracotomy(n=2). We followed up 63 patients for 6 months to 4 years. A total of 62 patients were well without reoperation except one death at the end of following-up 2 years. ConclusionBicuspid aortic valve combined with thoracic aortic dilation has diversiform clinical characteristics. The surgical treatment should be chosen according to the aortic valve and thoracic aortic lesion characteristics.

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  • 降主动脉置换治疗局部晚期食管癌一例

    Release date:2017-03-24 03:45 Export PDF Favorites Scan
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