Surgery for Type A Aortic Dissection – 中文旁白

OPERATOR: Jeng Wei, MD, MSD; Cheng-Hsin General Hospital
PATIENT: 46-year-old male
DIAGNOSIS: Chronic type A aortic dissection with intimal tear at the aortic arch, s/p axillo-femoral bypass due to small true lumen
OPERATION: Reconstruction of ascending aorta, aortic arch, and proximal descending thoracic aorta with vascular ring connectors ,Vasoring, and elephant trunk in type A aortic dissection.
PROCEDURE:
1. Bil carotid artery and Lt femoral artery for ECC
2. Occlude the arch arteries, Incise the ascending aorta, Insert the ringed graft in the aortic root, Cardioplegia
3. Making a double arm fresh elephant trunk with a Vasoring in the graft
4. Implant the distal free end of the elephant trunk in the proximal descending thoracic aorta with guide wire pulling technique, Fix the Vasoring to the arch between the innominate artery and the Lt carotid artery
5. Anastomose the Rt carotid arteries to the aortic graft, Anastomose the Lt carotid artery to the Lt subclavian artery, Anastomose the arch graft to the aortic root graft, Release the aortic clamp, Resume heart beating
6. Anastomose the Lt carotid artery graft to the Rt carotid artery graft.
RESULTS: Heart ischemic time: 90 minutes; Blood transfusion: 375 c.c.; Endotracheal extubation: 3 hours after operation