Surgical Experience For Treatment Of Thoracic Aortic Aneurysm And Aortic Dissection

Objective Discussion surgery treatment on various types of thoracic aortic aneurysm and aortic dissection.Methods February 2001 to March 2008 of 65 cases of surgical treatment of thoracic aortic aneurysm patients, 58 cases of man(89.78 percent), seven cases of women (10.77 percent). 18 to 71 years old, average age (46.03士11.67). Ascending aortic aneurysm-like expansion of six cases, aortic aneurysm-like expansion combined aortic valve insufficiency in 28 cases, Aortic dissection DeBakey type: Type I dissection 16 cases, TypeⅡdissection of 11 cases (three cases involving the dissection of the expansion arch), TypeⅡdissection of the merger mitral regurgitation 1 (dissection extension is not involved arch), TypeⅢdissection of two cases, the drop aortic aneurysm in one case. Emergency surgery four cases, deadline or elective surgery 61 cases. Bentall operation in 37 cases (17 of the routine of the wall parcels, three cases with the right atrial appendage anastomosis), Wheat operation in six cases, Bentall + mitral valve replacement in one case, Bentall + semi-arch replacement in four cases, Bentall operation + trunk surgery + descending aortic dissection stent in two cases, Bentall operation + all arch replacement + descending aortic dissection stent in three cases, aortic valve replacement + ascending aorta angioplasty in nine cases, descending aorta replacement in two cases, removal and repair of descending aortic aneurysm in one case, The establishment of CPB from femoral artery catheterization, top to bottom IVC intubation in 30 cases. The establishment of CPB from ascending aorta remote intubation, the right atrium drainage in 23 cases,nine cases establishment of CPB involving the dissection of the aorta of patients with deep hypothermic circulatory arrest, the right subclavian artery, the vena cava drainage from top to bottom, one case of DeBakey typeⅢa aortic dissection establishment of CPB from femoral artery catheterization, the right ventricle outflow of drainage, one case of DeBakey typeⅢa aortic dissection off-pump surgery, repair directly the descending aortic aneurysm with clamp tumor wall repair of excision.Results After Bentall operation + all arch replacement + descending aortic dissection stent recovery one cases died of intractable ventricular fibrillation;A case aortic dissection with acute renal failure patients preoperative,after Bentall operation died of renal failure increased in three days, after seven days one cases died of multiple organ failure.Other patients were cured and discharged. Conclusion Thoracic aortic aneurysm and aortic dissection over the 40-year-old male with multiple, high blood pressure and Marfan syndrome as the main cause of morbidity; Bentall operation is the treatment of thoracic aortic aneurysm and aortic dissection of the main procedures; Accurate and timely diagnosis and comprehensive preoperative evaluation, the appropriate procedure and skilled surgical techniques can be achieved more satisfactory results.