Clinical studying of thoracic endovascular aortic repair for treating multiple tears Stanford type B thoracic aortic dissection / 国际外科学杂志

Objective This study aims to analysis in the clinical features of Stanford type B thoracic aortic dissection with multiple tears,and to explore the clinical methods of thoracic endovascular aortic repair (TEVAR) treating this disease.Methods From February 2011 to May 2015,the cases that diagnosed with multiple tears (≥ two tears) Stanford type B thoracic aortic dissection and accepted operations with TEVAR at department of Thoracic Cardiovascular Surgery,Wuhan General Hospital of Guangzhou Command,were retrospective analyzed their clinical data.Except the first tear of proximal,cases were named for the treatment group whom used surgical methods treating distal aortic dissection tears.Otherwise,the cases were named non-treatment group.We compared the incidence of chest and back pain,the progress of distal aortic dissection,the changes of false lumen with aortic dissection,and the benefit of distal tears in two groups after 6 months after TEVAR.Results A total of 67 cases were recruited this retrospective study,successful operations with TEVAR were conducted in all patients,and no serious complications occurred postoperatively in all patients.7 cases with treatment group,60 cases with non-treatment group,no deaths within two groups in 6 months after TEVAR.There were no significance statistically in complained of the incidence of chest and back pain,and the rate of progress with distal aortic dissection (P ＞ 0.05).There was statistically significant in the rate of changes with false lumen with aortic dissection false lumen (P ＜ 0.05).Some cases with abdominal visceral artery blood flow from the distal tears of aortic dissection in the non-treatment (n =19).Conclusions TEVAR is an effective method for treating multiple tears Stanford type B thoracic aortic dissection.Distal tears should be individualized treatment according to the characteristics of Stanford type B thoracic aortic dissection or try not to deal with.

Clinical Efficacy of Thoracic Endovascular Aortic Repair for Treating the Patients With Complicated Thoracic Aortic Dissection / 中国循环杂志

Objective: To investigate the clinical efifcacy of thoracic endovascular aortic repair (TEVAR) for treating the patients with complicated thoracic aortic dissection and to report the relevant clinical experiences. Methods: We retrospectively analyzed the records of 56 patients with complicated thoracic aortic dissection who received the operation of TEVAR in our hospital from 2011-02 to 2015-10 in order to analyze their operation methods with reasons. Results: There were 21 patients with complex anatomic conditions for aortic arch, 7 of them received TEVAR and 14 received TEVAR with covered left subclavian artery; 16 patients with complex shape of aortic dissection, 5 of them received TEVAR and 11 received TEVAR with covered left subclavian artery; 19 patients with aortic dissection involving aortic arch, 17 of them received hybrid procedures of aortic arch branch bypass surgery + TEVAR and 2 received TEVAR with fenestrated stent grafts. All operations were successful and no severe complications occurred. Conclusion: TEVAR is a fast and effective method for treating complicated thoracic aortic dissection, which may expand the application ranges as covering left subclavian artery, branch vessel bypass and modiifed stent grafting.

The research status of the risk factors associated with thoracic aortic dissection / 国际外科学杂志

Thoracic aortic dissection was a catastrophic disease with change quickly,and the characteristic of thoracic aortic dissection was acute onset,complex,progress rapidly,difficult to diagnosis,and highly misdiagnosis rate.So the fatality rate of thoracic aortic dissection was high,which easy caused medical disputes.Even so,the cause of the formation of thoracic aortic dissection in detail is not clear,and many risk factors associated with the occurrence of thoracic aortic dissection.These including high blood pressure,gender (male),aortic normal aging,drug using,atherosclerosis,genetic disease and inflammatory diseases,etc.

Clinical significance of relationship between the myasthenia gravis and the WHO histological type & Masaoka clinical stages of thymoma / 国际外科学杂志

Objective To investigate the clinical significance of relationship between the myasthenia gravis and WHO histological types & Masaoka clinical stage of thymoma.Methods Retrospective analysis of resection specimen in thymoma and complete medical records in 81 cases from December 2004 to September 2009,using the analysis of statistical software between myasthenia gravis and both thymoma Masaoka clinical stages & the WHO histological types.Results The difference of merger with MG of thymoma Masaoka among different clinical stages was statistically significant (P ＜ 0.05).The difference of merger with MG Thymoma WHO among different histological types was statistically significant (P ＜ 0.05).The difference of thymoma Masaoka between the WHO histological type and Masaoka clinical stages was statistically significant (P ＜ 0.05,kappa =0.580,C =0.503).Conclusions There are some relationships between thymoma Masaoka clinical stages and MG,so had some relationships between thymoma WHO histological types and MG.At the same time,the thymoma WHO histological types reflects the Masaoka clinical stages in a certain extent.This relationship would be used as one of the important indicators to evaluate the prognosis of patients at some extent.