Advances in treatment for Stanford type B aortic dissection / 基础医学与临床

Type B aortic dissection(TBAD)is a life-threatening aortic disease.Complicated TBAD patients require emergency surgical procedure to prevent death caused by rupture or severe complication.The development of endo-vascular repair has shifted the management from extensive open surgical to minimally less invasive endovascular strategy.Thoracic endovascular aortic repair(TEVAR)may promote aortic remodeling and prevent late aneurysmal dilatation,more and more evidences show that TEVAR is effective in the treatment of uncomplicated TBAD.

Long-term outcome of correction of tetralogy of Fallot in 56 adult patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although most patients with tetralogy of Fallot undergo radical repair during infancy and childhood, patients that remain undiagnosed and untreated until adulthood can still be treated. This study aimed to evaluate longterm outcomes of adult patients with tetralogy of Fallot who were treated surgically, and to determine the predictors of postoperative pulmonary regurgitation.</p><p><b>METHODS</b>Fifty-six adult patients underwent complete surgical repair. Forty-three patients (76.8%) required a transannular patch. Systolic, diastolic, and mean pressure in the main pulmonary artery were measured after repair.</p><p><b>RESULTS</b>The early mortality rate was 3.6%. The 16-year survival rate was (84.4 ± 11.5)%. Late echocardiography revealed 41 patients with transannular patch who had pulmonary regurgitation, consisting of mild pulmonary regurgitation in 28 patients, moderate in eight, and severe regurgitation in five patients. In addition, there was right ventricular outflow tract stenosis in nine patients, moderate/severe tricuspid valve regurgitation in seven, and residual ventricular septal defect in five. Logistic regression analysis demonstrated that the mean pulmonary pressure measured just after repair predicted late pulmonary regurgitation.</p><p><b>CONCLUSIONS</b>The long-term survival of surgically treated adult patients with tetralogy of Fallot is acceptable. The mean pressure >20 mmHg in the main pulmonary artery measured right after surgical repair may be a feasible reference to time the reconstruction of the pulmonary valve.</p>