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:
Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China Management of Aortic Dissection----New classification and Mid-term results Dinghua Yi, et al
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
Zone 1 Zone 3 Zone 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
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.)
Frozen elephant trunk technique was applied in patients with multiple tears (Zone 1 +Zone 2,3,4)
Ascending aorta to bilateral common carotid artery bypass should be established before endovascular exclusion for primary tears in Zone 2.
Bilateral common carotid artery bypass should be established before endovascular exclusion for primary tears located in the Zone 3.
TEVAR became the gold standard for dissection with primary tears in Zone 4
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
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