Combination of tevar and open repair for aortic dissecting aneurysms

COMBINATION OF TEVAR AND OPEN REPAIR FOR AORTIC DISSECTING ANEURYSMS Nguyen Thai An, M.D A/Prof.. Trần Quyết Tiến, M.D, Ph.D Cho Ray Hospital... AIMS OF STUDY• ESTIMATE the results of

COMBINATION OF TEVAR AND OPEN REPAIR

FOR AORTIC DISSECTING ANEURYSMS

Nguyen Thai An, M.D A/Prof Trần Quyết Tiến, M.D,

Ph.D Cho Ray Hospital

Cho Ray hospital: in Ho Chi Minh, South of Vietnam

- 1000 cases /year

Started TEVAR in 2012

76 yo man

Ascending aorta=43mm

AIMS OF STUDY

• ESTIMATE the results of open surgery

and TEVAR in extensive aortic dissecting aneurysm

STUDY METHOD

• Prospective cohort study

• Single center

• 2013-2016

• Extensive diseaes: Ascending

Aneurysm/dissection + arch and descending aneurysm/ dissection

• Staged or hybrid operations

• Open suregry: ascending replacement

+ total debranching, ascending and

total arch replacement + elephant trunk

or not

• TEVAR retrogradely

• FOLLOW-UP : CT scan 3,6,12 months

post-op

• Asc repl + total debr : 2

• Asc and arch repl : 14

• CABG: 1

• Staged: 2

• Average of stent number: 2

• 30-DAY mort : 1/16= 5.88%

• Paraplegia: 0

• Bleeding: 0

Why not frozen elephant trunk?

post TEVAR-Acute type A

dissection

• Female

• 45yo

• Acute type B dissection

• Left pleural effusion,

• Partial ischemia of left kidney

• TEVARs: descending thoracic, celiac

and SMA debranching+stent graft

First CT scan Post TEVARs

New dissection type A

• Ascending aorta surgical replacement

combined with stented elephant trunk has good mid- term outcomes

THANK YOU FOR YOUR ATTENTION