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find Author "王振捷" 2 results
  • Extended Resection and Reconstruction of Superior Vena Cava and Innominate Vein for Mediastinal Tumor

    ObjectiveTo report the effect and experience of the extended resection and reconstruction of superior vena cava(SVC) and innominate vein for invasive mediastinal tumors.MethodsA retrospective study of 11 patients who underwent extended resection and grafts of SVC and innominate vein for invasive mediastinal tumor in Peking Union Medical College Hospital from 2001 to 2003 was performed. Radical resection was performed in 9 cases, among which SVC and left innominate vein were reconstructed with pericardium patch in 2, with prostheses(ringed GoreTex) interposed in 7.The other 2 patients who had incomplete resection also underwent prostheses interposition for SVC reconstruction. During operation, SVC and left innominate vein were clamped in turn,to avoid total interruption of blood return, clamping time for each site was 22.15±6.29 min. The volume of blood loss was 1 342.86± 692.48ml during operation.ResultsThe tumor included 4 invasive thymoma, 5 thymic cancer, 2 primary mediastinal small cell carcinoma. The patency was good in the grafts with external ring support and no SVC symptoms were observed in all cases postoperatively. One patient died of respiratory infection two weeks after operation, others are alive till now. The longest patent and functional graft is 30 months postoperatively.ConclusionSVC and innominate vein reconstruction by prostheses interposition can effectively eradicate the SVC syndrome. Clamping SVC needs careful study. Attention to the invasive extention of tumor should be made to avoid palliative operation,because complete resection is most important for long term survival.

    Release date:2016-08-30 06:24 Export PDF Favorites Scan
  • 双侧乳内动脉在冠状动脉旁路移植术中的应用

    目的 总结使用双侧乳内动脉做冠状动脉旁路移植术(CABG)材料的临床经验. 方法 回顾性临床研究42例冠心病患者接受双侧乳内动脉行CABG的方法、适应证和乳内动脉的选择应用. 结果 共完成83个乳内动脉吻合,同时使用桡动脉吻合56个,平均每例患者接受血管移植3.3根(2~6根).术后合并围手术期心肌梗死1例,急性呼吸窘迫综合征(ARDS)2例.本组死亡4例,其中因心力衰竭、心律失常死亡2例,肠穿孔1例,下肢缺血性坏死和败血症1例.随诊12~60个月,除1例心绞痛复发外,其他患者均无症状存活,生活质量明显改善. 结论 使用双侧乳内动脉虽较用大隐静脉做CABG稍复杂,但仍可在适合的病例广泛采用,包括较危重的冠心病、糖尿病、不稳定型心绞痛和左主干病变的患者.乳内动脉所具有的解剖特性能提高移植血管的长期通畅性,极低的再狭窄率,可明显提高患者的生活质量.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
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