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find Keyword "杂交手术" 39 results
  • “一站式”杂交技术在冠状动脉多支血管病变中的临床应用

    目的探讨“一站式”杂交技术治疗冠状动脉多支血管病变的安全性及治疗效果。方法回顾性分析我院 2018 年 8 月至 2019 年 8 月行“一站式”杂交技术冠状动脉血运重建 22 例冠状动脉多支血管病变患者的临床资料,其中男 16 例、女 6 例,平均年龄 50~81(60.5±8.2)岁。患者在杂交手术室先完成经左胸小切口冠状动脉旁路移植术,之后行冠状动脉介入治疗术。回顾性分析患者围术期资料,并进行随访,采用 SF-36 量表评估患者术后 3 个月生活质量以及观察随访期间主要不良心脑血管事件(MACCE)发生情况。结果该组患者围术期无死亡病例,住院期间无严重并发症发生。随访 3 个月至1 年,随访期间 1 例患者发生脑卒中,无其它 MACCE 发生,生活质量明显改善。结论“一站式”杂交冠状动脉血运重建治疗冠状动脉多支血管病变安全有效,近期疗效满意。

    Release date:2020-12-07 01:26 Export PDF Favorites Scan
  • Early outcomes of two-stage Hybrid surgery in patients aged over 80 years with multivessel coronary artery disease

    Objective To observe the short-term efficacy and the incidence of adverse cardiovascular events in patients aged over 80 years with multivessel coronary artery disease following two-stage Hybrid surgery. Methods We retrospectively analysed the clinical data of 67 patients aged over 80 years with multivessel coronary artery disease undergoing surgery in our hospital. The were 44 males and 23 females with an anverage age of 82.4±2.1 years. According to the operation pattern, the patients were divided into two groups: a two-stage Hybrid surgery group (n=29, 19 males, 10 females, aged 83.2±3.1 years) and a traditional thoracotomy group (n=38, 25 males, 13 females, aged 83.3±3.4 years). We compared the clinical results of perioperation between the two groups. Results Conpared with the traditional thoracotomy group, the two-stage Hybrid surgery group had shorter postoperative duration of mechanical ventilation (6.7±2.2 hvs. 18.2±3.4 h) and hospitalization stay (15.7±3.0 dvs. 20.7±5.6 d) and had less volume of chest drainage during the first 24 h after surgery (176.5±32.3 mlvs. 443.8±51.5 ml). The incidence of adverse cardiovascular events in the two-stage Hybrid surgery group was significantly lower than that in the traditional thoracotomy group (6.9%vs. 23.1%, P<0.05). Conclusion The two-stage Hybrid surgery in patients aged over 80 years with multivessel coronary artery disease can significantly decrease the postoperative incidence of adverse cardiovascular events, shorten the postoperative duration of mechanical ventilation and hospitalization stay, reduce the volume of chest drainage during the first 24 h after surgery and improve prognosis of surgery for the elderly patients.

    Release date:2017-09-26 03:48 Export PDF Favorites Scan
  • 分期杂交手术治疗胸腹主动脉夹层

    目的总结腹主动脉去分支化手术联合主动脉腔内隔绝术治疗胸腹主动脉夹层的经验。方法自 2018 年 1 月至 2019 年 6 月,南京鼓楼医院采用腹主动脉去分支化手术联合主动脉腔内隔绝术治疗胸腹主动脉夹层 12 例,男 10 例、女 2 例,年龄 36~63(50±9)岁。结果随访 6~24 个月,全组无死亡,1 例术后左下肢单瘫,1 例出现肾功能不全。随访期间 1 例患者术后 1 个月出现主动脉支架近端逆撕,行全主动脉弓置换术后痊愈。2 例患者出现腹腔干动脉近端内漏,予以弹簧圈栓塞后痊愈,其余患者 CT 血管造影(CTA)检查未见吻合口造影剂渗漏及人工血管扭曲、闭塞。结论腹主动脉去分支化手术联合主动脉腔内隔绝术治疗胸腹主动脉夹层可取得良好近期疗效,中远期疗效仍有待进一步观察随访。

    Release date:2020-09-22 02:51 Export PDF Favorites Scan
  • Short-term outcome of ascending aorta replacement combined with total aortic arch fenestration technique for acute type A aortic dissection

    ObjectiveTo report our clinical experience and outcomes of thoracic endovascular aortic repair (TEVAR) for acute Stanford type A dissection using ascending aorta replacement combined with implantation of a fenestrated stent-graft of the entire aortic arch through a minimally invasive technique. MethodsFrom 2016 to 2020 in our hospital, 24 patients (17 males and 7 females, aged 45-72 years) with complicated Stanford type A aortic dissection, underwent replacement of the proximal ascending aorta with TEVAR. None of the patients with dissection involved the three branches of the superior arch, and all patients were replaced with artificial blood vessels of the ascending aorta under non-hypothermic cardiopulmonary bypass, preserving the arch and the three branches above the arch, and individualized stent graft fenestration. ResultsSurgical technical success rate was 100.0%. There was no intraoperative complication or evidence of endo-leak in 1 month postoperatively. Hospital stay was 10±5 d. During postoperative follow-up, the stent was unobstructed without displacement, the preserved branch of the aortic arch was unobstructed, and the true lumen of the descending aorta was enlarged. Conclusion This hybrid technique by using TEVAR with fenestrated treatment is a minimally invasive and effective method to treat high-risk patients with acute Stanford type A aortic dissection.

    Release date:2022-05-23 10:52 Export PDF Favorites Scan
  • 降主动脉“逆行”去分支与主动脉腔内修复术杂交治疗 Stanford A 型主动脉夹层

    Release date:2017-09-26 03:48 Export PDF Favorites Scan
  • Clinical effect of ascending aorta banding combined with typeⅠ hybrid aortic arch repair on aortic arch diseases

    Objective To assess the efficacy and safety of ascending aorta banding technique combined with typeⅠhybrid aortic arch repair for the aortic arch diseases. Methods The clinical data of patients undergoing ascending aorta banding technique combined with type Ⅰ hybrid arch repair for aortic arch diseases from March 2019 to March 2022 in Beijing Anzhen Hospital were retrospectively analyzed. The technical success, perioperative complications and follow-up results were evaluated. Results A total of 44 patients were collected, including 35 males and 9 females, with a median age of 63.0 (57.5, 64.6) years. The average EuroSCORE Ⅱ score was 8.4%±0.7%. The technical success rate was 100.0%. All patients did not have retrograde type A aortic dissection and endoleaks. One patient died of multiple organ failure 5 days after operation, the in-hospital mortality rate was 2.3%, and the remaining 43 patients survived and were discharged from hospital. The median follow-up period was 14.5 (6-42) months with a follow-up rate of 100.0%. One patient with spinal cord injury died 2 years after hospital discharge. One patient underwent thoracic endovascular aortic repair at postoperative 3 months due to new entry tears near to the distal end of the stent. Conclusion Ascending aorta banding combined with typeⅠhybrid arch repair for the aortic arch diseases does not need cardio-pulmonary bypass. Ascending aorta banding technique strengthens the proximal anchoring area of the stent to avoid risks such as retrograde type A dissection, endoleak and migration. The operation owns small trauma, rapid recovery, low mortality and a low rate of reintervention, which may be considered as a safe and effective choice in the treatment of the elderly, high-risk patients with complex complications.

    Release date:2024-09-20 12:30 Export PDF Favorites Scan
  • Advance in hybrid repair of chronic thoracoabdominal aortic dissecting aneurysm

    Surgical intervention for chronic thoracoabdominal aortic dissecting aneurysms (cTAADA) is regarded as one of the most challenging procedures in the field of vascular surgery. For nearly six decades, open repair predominantly utilizing prosthetic grafts has been the treatment of choice for cTAADA. With advances in minimally invasive endovascular technologies, two novel surgical approaches have emerged: total endovascular stent-graft repair and hybrid procedures combining retrograde debranching of visceral arteries with endovascular stent-graft repair (abbreviated as hybrid procedure). Although total endovascular stent-graft repair offers reduced trauma and quicker recovery, limitations persist in clinical application due to hostile anatomical requirements of the aorta, high costs, and the lack of universally available stent-graft products. Hybrid repair, integrating the minimally invasive ethos of endovascular repair with visceral artery debranching techniques, has increasingly become a significant surgical modality for managing thoracoabdominal aneurysms, especially in cases unsuitable for open surgery or total endovascular treatment due to anatomical constraints such as aortic tortuosity or narrow true lumens in dissections. Recent enhancements in hybrid surgical approaches include ongoing optimization of visceral artery reconstruction strategies based on hemodynamic analyses, and exploration of the comparative benefits of staged versus concurrent surgical interventions.

    Release date:2024-06-20 05:33 Export PDF Favorites Scan
  • Progress in Minimally Invasive Surgery for Atrial Fibrillation

    Atrial fibrillation (AF) is difficult to cure for its complex etiology and long disease duration. Heart failure, sudden death and stroke are the main causes for consequent high mortality and morbidity. In recent years, minimally invasive surgery has made rapid progress, not only improved treatment efficiency of traditional Cox Maze procedure but also massively reduced surgical injuries, and has become a preferred treatment strategy for lone AF. Minimally invasive surgery and catheter ablation complement each other, and are likely to open up a new prospect of AF treatment.

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  • HYBRID PROCEDURES FOR MULTILEVEL FEMORAL AND POPLITEAL ARTERY OCCLUSIVE DISEASE

    Objective To evaluate the immediate and mid-term effectiveness of hybrid procedures (combined open surgery and endovascular therapy) for multilerel femoral and popliteal artery occlusive disease. Methods Between June 2009 and June 2012, 22 cases of severe femoral and popliteal artery occlusive disease were treated by hybrid surgery. There were 15 men and 7 women with an age range of 52-78 years (mean, 66.2 years) and with a disease duration of 6 months to 5 years (mean, 1.5 years). Of 22 patients, 13 had a history of smoking; 8 were classified as Fontaine III and 14 as Fontaine IV. The complications included diabetes (8 patients), hypertension (16 patients), hyperlipemia (10 patients), coronary heart disease (11 patients), and chronic kidney failure (1 patient). Patency analyses were performed using Kaplan-Meier life tables and log-rank test. Results All patients underwent successfully procedures. The time of operation was 70-160 minutes (mean, 137 minutes). Acute myocardial infarction, hematoma of incision, fracture of stent, and stent thrombosis occurred in 1 case, respectively. At 6 months after surgery, the ankle brachial index (ABI), the transcutaneous oxygen pressure (TcpO2), and the average intermittent claudication distance were significantly increased when compared with preoperative ones [0.79 ± 0.33 vs. 0.32 ± 0.18, (42.7 ± 15.7) kPa vs. (17.6 ± 11.6) kPa, and (420 ± 80) m vs. (160 ± 54) m, P lt; 0.05]. The patients were followed up 6-24 months (mean, 14.5 months). The primary patency rate, primary assisted patency rate, and second patency rate were 77.3% (17/22), 90.9% (20/22), and 95.5% (21/22) respectively, showing no significant difference among them (P gt; 0.05). No significant difference was found in various-stage patency rates between patients at Fontaine III and IV (P gt; 0.05). Conclusion Hybrid procedures provide an effective treatment of multilevel femoral artery and popliteal artery disease while there is good outflow.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • Open Surgical Repair Combined with Endovascular Repair for Arterial Disease

    Release date:2016-09-08 10:45 Export PDF Favorites Scan
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