Transcatheter aortic stent placement for aortic dissection

     in September 29, 2009, our hospital radiology and interventional center of cardiovascular surgery, anesthesiology, close

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    in September 29, 2009, our hospital radiology and interventional center of cardiovascular surgery, anesthesiology, close cooperation, for the implementation of successful endovascular repair of aortic stent in a 31 year old patients with aortic dissection, to save a young life.

        the patient is a 31 year old male with acute chest pain "to a large hospital Daocheng treatment, diagnosis of aortic dissection, then transferred to the Qingdao Fuwai Cardiovascular Disease Hospital Heart Center for treatment. Patients in Fuwai Hospital, were examined by CT, found that the cumulative lesions range, and the presence of multiple holes and then break the sandwich, and in the presence of problems of splenic embolism and poor renal function, patients at any time of danger. In the face of serious illness, Radiology, interventional center Professor Xu Zhongying and Dean Li Jiongyi decisive decision: immediate action, active anti hypertension treatment, improve the examination for the patient and endovascular repair of aortic stent.

        at 8 a.m. on September 29th, the patient was sent to the radiology department room calmly. The medical staff is the vital signs monitoring. Immediate use of anesthesia, anesthesia induction, the blood pressure to maintain normal levels. After tracheal intubation, radial artery, internal jugular vein puncture, closely monitor the vital signs. Surgical operation of the femoral artery through the radial artery through the subclavian artery. Were found descending aorta has multiple lacerations, the break distance of celiac close by intimal flap tear spirally and then break, the true lumen is minimal, lesions to the right femoral artery, which brought great difficulties to the operation.

        after careful study, the doctor decided to implant the left femoral artery stent. Angiography, positioning, stent expansion, repeated angiography, surgery was successful, postoperative display: support accurate release, true lumen expansion, the proximal crevasse closed, distal blood flow was improved, operation success! The whole operation lasted 2 hours, the patient's risk to the exclusion of patients, postoperative recovery and rehabilitation has been discharged.

        according to the reported literature, such as complex and high risk patients with dissection, treated by transcatheter aortic stent graft endovascular repair, so far as our hospital in Shandong province is the youngest of a successful case. This marks the successful surgery patients in our hospital aorta interventional treatment and on a higher level, and provides valuable experience for young high-risk patients with complex aortic disease interventional therapy.

        radiology intervention center in support of hospital leaders, related closely with experts in Beijing led the team to tackle tough, the first-class intervention center in a high starting point, high on the target platform. Interventional treatment of cardiovascular interventional therapy, especially, congenital heart disease interventional therapy of aortic disease and peripheral vascular interventional treatment for features, to fill the Qingdao city number of gaps, and the "Fu" high-end technology successfully shifted to Qingdao, to the Shandong Peninsula region radiation technology gradually.

Figure   preoperative CT films show a wide range of intercalation, the complexity of the situation.

Figure two   intraoperative stent implantation after angiography showed stent in place, the results were satisfactory.

Figure three   after CT review, the morphology of the scaffolds in good position, the false lumen narrowing, true lumen expansion, the proximal crevasse closed, distal blood flow improved, successful operation.

 

                                                                                                  Yang Chengwei

 

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