Phối hợp stentgraft và mở hở với bệnh phồng lóc động mạch chủ

COMBINATION OF TEVAR AND OPEN REPAIR FOR AORTIC DISSECTING ANEURYSMS Nguyen Thai An, M.D Chief, Department of Intensive Care and Cardiac Surgery, Cho Ray Hospital... AIMS OF STUDY • ES

COMBINATION OF TEVAR AND OPEN REPAIR

FOR AORTIC DISSECTING ANEURYSMS

Nguyen Thai An, M.D Chief, Department of Intensive Care and Cardiac Surgery,

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

• Cohort study

• Single center

• 2013-2016

• Extensive diseaes: Ascending

Aneurysm/dissection + arch and

descending aneurysm/ dissection

• Staged or hybrid operations

PROCEDURES

• 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

RESULTS

• Asc repl + total debr : 2

• Asc and arch repl : 14

• CABG: 1

• Staged: 2

• Average of stent number: 2

RESULTS

• 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

Conclusion

• Ascending aorta surgical replacement

combined with stented elephant trunk has good mid- term outcomes

THANK YOU FOR YOUR ATTENTION