RESUMEN
Objective:To evaluate the safety and efficacy of balloon occlusion technique combined with total arch replacement and frozen elephant trunk in the treatment of complex aortic arch diseases.Methods:The clinical data of 100 patients undergoing balloon occlusion technique combined with total arch replacement and frozen elephant trunk surgery in Fuwai Hospital from August 2017 to September 2018 were retrospectively reviewed, and the early clinical results were analyzed.Results:The average circulatory arrest time was(5.2±3.1) min. The lowest nasopharyngeal and bladder temperature was(27.9±1.0) ℃ and(29.2±1.2) ℃, respectively. One patient died in hospital due to multiple organ failure caused by acute liver failure, and a total of 4 patients died within 30 days. Other postoperative complications included cerebral infarction in 3 cases, paraplegia in 2 cases, low cardiac output syndrome requiring IABP assistance in 1 case, renal failure requiring continuous dialysis in 5 cases, redo for bleeding in 4 cases, reintubation in 3 cases, recurrent laryngeal nerve injury in 1 case, and osteofascial compartment syndrome in 1 case.Conclusion:Balloon occlusion technique combined with total arch replacement and frozen elephant trunk is safe and feasible in the treatment of complex aortic arch diseases. Its organ protection effect still needs to be confirmed by large sample comparison study.
RESUMEN
Objective To study the surgical treatment strategy of acute type A aortic dissection involving coronary artery on the basis of Fuwai type and evaluate the clinical efficacy. Methods 50 patients with coronary involvement were retrospec-tively analyzed from April 2014 to August 2016. The treatment mothod was based on Fuwai type,mainly including coronary ar-tery repair(CAR)and coronary artery bypass grafting(CABG). The clinical effect of this surgical strategy in the perioperative and follow-up period was analysed. Results A total of 50 patients were included. Of which,38 patients were treated with CAR, 12 patients CABG,including 3 remedial bypass and 2 prophylactic bypass. All patients were followed up from 4 to 32 months,with an average time of 18. 6 months. In group CABG, 1 patient died of multiple organ failure after surgery,and the other patients had no major adverse cardiovascular events and deaths during perioperative period and follow-up period. Conclu-sion This strategy for the treatment of involved coronary arteries based on the Fuwai type has some guiding significance on the surgical treatment of acute type A aortic dissection.