Surgical management of thoracic aortic aneurysm combined with coronary artery disease / 中华胸心血管外科杂志

Objective: To review the experience of one-stage surgical management of thoracic aortic aneurysm associated with coronary artery disease. Methods: From June 1999 to July 2002, fifteen patients (all the male, average age 57.21 year-old, ranged 40-66 year-old) underwent thoracic aortic aneurysm repair and concomitant coronary revascularization. The diagnosis are aortic root aneurysm in 5 cases,ascending aortic aneurysm in 2,arch aortic aneurysm in 3,and aortic dissecting in 5. 14 patients received operation through midsternotomy,including ascending aorta replacement in 2, Bentall technique in 4, David technique in 1 and total arch replacements in 3 patients. Left thoracotomy and off-pump CABG was done in 1 case. Results: 1 patient died in 30 days after operation. Followed up for a mean duration of 17 months,there were no late death and no reoperation and no related events occurred. Conclusion: Thoracic aortic replacement and CABG (coronary artery bypass grafting) could be done at one-stage. Concomitant coronary revascularization may aggressively obviate CAD events.

Surgical management of aortic diseases / 中国普通外科杂志

Objective To explore the surgical management of aortic diseases. Methods The clinical data of 45 cases of aortic diseases were analysed retrospectively. Results There were 37 males and 8 females.The age ranged from 21 85 years with a mean age of 64.7 years, Among these cases, 11 were thoracic aortic dissection, 2 were ruptured descending aortic local dissection and formed an aneurysm;above and below the renal artery abdominal aortic aneurysms( AAAs) were 3 and 23 respectively; complicated with rupture of the AAA in 2, and with aortojejumal fistula in 1;the other 3 cases were traumatic aortal rupture. Among the 45 cases, 18 underwent endoluminal treatment, 25 underwent AAA resection and artificial vessel implantment, and 3 underwent repair of the ruptured aorta. The operative mortality was 6.67% ( 3/45 ). 36 patients were followed up for 2 months to 4 years, all the 36 patients still alive well. Conclusions In the management of appropriate aortic diseases, endoluminal technique is much simple,safe, less trauma, and less complications, it can also short the hospital stay of the patient . However, with improvement of the surgical skills,the surgical operation is still very important and effective, especially for the cases who can not be treated via endovascular technique.

Endovascular stent-graft repair of aortic dissection / 中国普通外科杂志

Objective To introduce the experience in endovascular stent graft repair (EVSGR) of thoracoabdominal aortic dissecting aneurysm (TAADA). Methods Retrospective analysis was made on the management of 6 patients with TAADA from October 2000 to June 2001. Results There were six male patients aged 42～72 in this series. Of them, 5 patients with Stanford type B TAADA and one with Stanford A TAADA. Of the 6 patients, The fissures were sealed and the dissections were disappeared completely in 5 cases; one case shifted to open surgery for abdominal aortic fenestration, Rupture of the iliac dissection occurred in 1 case 3 days after EVSGR, then the abdominal aortic fenestration and graft replacement of distal abdominal aorta were performed. One patient died of heart infarction on the third day postoperatively. Five cases were followed-up for 1～9 months, they all were alive and well. Conclusions Endovascular stent graft technique is safe and simple in repairing of TAADA, and abdominal aortic fenestration is an adjuvant procedure.