In the present study, we reported our experience with partial aortic root remodeling for root reconstruction in patients with acute type A dissection, which involves in non-coronary sinus and/or the right coronary sin...In the present study, we reported our experience with partial aortic root remodeling for root reconstruction in patients with acute type A dissection, which involves in non-coronary sinus and/or the right coronary sinus with just one trimmed Dacron graft. Between February 2001 and May 2010, we performed partial aortic root remodeling in 40 patients, who underwent emergency surgical intervention. The dissected sinuses were excised leaving a 3-5 mm rim of the aortic wall from the attached aortic valve cusps. A short piece (4-5 cm) of collagen coated woven polyester vascular prosthesis was trimmed with one or two "tongues" to reconstruct the non-coronary sinus and/ or the right coronary sinus, but without using separated patches. Additional procedures were including hemi-arch replacement in 11 patients, and total arch replacement plus stent-elephant trunk in 20 patients. The mean follow-up time was 36.4~3.6 months. In-hospital mortality was only 5.0% (2/40); furthermore, 3 (8.6%) patients underwent re-operation of the aortic valve and 2 (5.7%) patients died during follow-up. At the end of follow-up, trivial or no aortic regurgitation was found in 33 patients, but mild aortic regurgitation was found in 2 patients. Our data suggest that the early and mid-term results of partial aortic root remodeling were favorable, and it restored valve durability and function. Thus, the use of technique for root reconstruction in patients with acute type A dissection should be vigorously encouraged.展开更多
Thoracic endovascular aortic repair(TEVAR)has been considered as a first-choice treatment for type B aortic dissection(TBAD).However,some patients that is lack of optimal landing zones(<15 mm in dissected Z2,Z3 or ...Thoracic endovascular aortic repair(TEVAR)has been considered as a first-choice treatment for type B aortic dissection(TBAD).However,some patients that is lack of optimal landing zones(<15 mm in dissected Z2,Z3 or the presence of a lusorian artery)still pose significant challenges for TEVAR.We utilized a surgical stent-graft implantation in the descending aorta combined with supra-aortic vessels transposition through median sternotomy for these special TBAD patients.The short-and mid-term results showed that our procedure is a good and alternative therapy for such kind patients.展开更多
Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascula...Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and pasteurization.The medical use of HAS could date back to approximately the time of World War II.展开更多
文摘In the present study, we reported our experience with partial aortic root remodeling for root reconstruction in patients with acute type A dissection, which involves in non-coronary sinus and/or the right coronary sinus with just one trimmed Dacron graft. Between February 2001 and May 2010, we performed partial aortic root remodeling in 40 patients, who underwent emergency surgical intervention. The dissected sinuses were excised leaving a 3-5 mm rim of the aortic wall from the attached aortic valve cusps. A short piece (4-5 cm) of collagen coated woven polyester vascular prosthesis was trimmed with one or two "tongues" to reconstruct the non-coronary sinus and/ or the right coronary sinus, but without using separated patches. Additional procedures were including hemi-arch replacement in 11 patients, and total arch replacement plus stent-elephant trunk in 20 patients. The mean follow-up time was 36.4~3.6 months. In-hospital mortality was only 5.0% (2/40); furthermore, 3 (8.6%) patients underwent re-operation of the aortic valve and 2 (5.7%) patients died during follow-up. At the end of follow-up, trivial or no aortic regurgitation was found in 33 patients, but mild aortic regurgitation was found in 2 patients. Our data suggest that the early and mid-term results of partial aortic root remodeling were favorable, and it restored valve durability and function. Thus, the use of technique for root reconstruction in patients with acute type A dissection should be vigorously encouraged.
基金supported by grants from the Young Program of National Natural Science Foundation of China(No.81600225)the Young Program of the Natural Science Foundation of Jiangsu Province(No.BK20160132)Jiangsu Province Special Program of Medical Science(BE2017610)
文摘Thoracic endovascular aortic repair(TEVAR)has been considered as a first-choice treatment for type B aortic dissection(TBAD).However,some patients that is lack of optimal landing zones(<15 mm in dissected Z2,Z3 or the presence of a lusorian artery)still pose significant challenges for TEVAR.We utilized a surgical stent-graft implantation in the descending aorta combined with supra-aortic vessels transposition through median sternotomy for these special TBAD patients.The short-and mid-term results showed that our procedure is a good and alternative therapy for such kind patients.
文摘Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and pasteurization.The medical use of HAS could date back to approximately the time of World War II.