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Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China Management of Aortic Dissection----New classification and Mid-term results Dinghua Yi,

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Presentation on theme: "Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China Management of Aortic Dissection----New classification and Mid-term results Dinghua Yi,"— Presentation transcript:

1 Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China Management of Aortic Dissection----New classification and Mid-term results Dinghua Yi, et al

2 Criado Zonation , 2005 (According to stent graft, suitable for aneurysm) Xijing Classification, 2006 ( According to primary tear, suitable for dissection ) Zones based on hybrid procedure

3 Zone 1 Zone 3 Zone 4

4  From December 2001 to June 2009  525 patients (492 male, 33 female)  The average age of 49.2 years old (37 ~ 73)  Acute dissection 491  Chronic dissection 34 Materials and Methods

5 For dissection with primary tears in Zone 1 (+2,3,4), open surgery remains the gold standard (including Bentall, total arch replacement, concomitant CABG etc.)

6 Frozen elephant trunk technique was applied in patients with multiple tears (Zone 1 +Zone 2,3,4)

7 Ascending aorta to bilateral common carotid artery bypass should be established before endovascular exclusion for primary tears in Zone 2.

8 Bilateral common carotid artery bypass should be established before endovascular exclusion for primary tears located in the Zone 3.

9 TEVAR became the gold standard for dissection with primary tears in Zone 4

10 Results Mortality Rate  Procedure related Complications  Heart failure  Renal failure  Cerebral insufficiency  Infection  Endoleak  Hepatic insufficiency  Iatrogenic dissection 6.7% 3.3% 2.1% 0.6% 0.4% 0.6% 1.1% 0.4%

11 Defining zones according to the tear location is useful for planning a hybrid approach Zone 3 : Carotid Bypass+TEVAR Zone 4: TEVAR Zone 1 : Ascending Aorta Replacement Zone 2 : Ascending aorta Bypass +TEVAR Discussion

12 Jian Yang, Jian Zuo, Lifang Yang, and Dinghua Yi. Endovascular stent-graft treatment of thoracic aortic dissection. Interact CardioVasc Thorac Surg 2006;5: Liu JC, Zhang JZ, Yang J, Yi DH et al. Combined Interventional and Surgical Treatment for Acute Aortic Type A Dissection. Cardiovasc Intervent Radiol 2008;6:151-6 Jian Yang, Jincheng Liu, Dinghua Yi. Comparisons of two Hybrid Approaches in treating Complex Aortic Dissection. International Congress XXI on Endovascular Interventions Phoenix, USA Publications


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