慢性肺栓塞的外科治疗_宋云虎演示幻灯片.pptVIP

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2018-02-23 发布于天津
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慢性肺栓塞的外科治疗_宋云虎演示幻灯片.ppt

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Fuwai Hospital PEA is a safe and effective method to treat CTEPH and with satisfactory mid- and long-term resultspreop evaluation system supposed to be perfectedpostop treatment needs further exploration and standization Fuwai Hospital Fuwai Hospital CLINICAL MANIFESTATION Effort dyspnea 44 Lower extremites edema 35 syncope 7 hemoptysis 13 ascite 1 DVT 30 Fuwai Hospital Bilateral disease 32 cases Unilateral disease 14 cases Fuwai Hospital OPERATION METHODS deep hypothermic circulatory arrest or low flow thromboendarterectomy Treat associated cardiac disorders Fuwai Hospital Mean CPB time: 160.3min Mean AOC time: 72.2min Mean cardiac arrest time: 44.6 min Associated management TVP 6 CABG 1 PVP 1 Fuwai Hospital Expose RPA and RPA incision Expose LPA and LPA incision Fuwai Hospital RPA incision Resection plane initiated Fuwai Hospital Create resection plane Fuwai Hospital Fuwai Hospital Fuwai Hospital Fuwai Hospital RESULTS Fuwai Hospital OP mortality: 8.7% (4/46) Mean intubation time: 75.2 h Pulmonary edema: 10（21.7％） Early postop-severe PH: 6（13.0％） CNS complication: 7（15.2％） Fuwai Hospital Fuwai Hospital PRE-OP 7 DAYS POST-OP CTA changes female, 53 yrs, CPE in RPA Fuwai Hospital preop 1 mon postop male，53 yrs， CPE in RPA 1 yr postop CTA changes Fuwai Hospital preop postop Fuwai Hospital preop postop Fuwai Hospital Pulmonary perfusion improved postop preop 3 mon postop Case 1: male, 53 yrs Case 2: male, 48 yrs preop 6 mon postop Fuwai Hospital FOLLOWUP Cases followed 38 Followup time(mon) 27.3（2-122） death 4 CTEPH associated re-hospitalization 1 Bleeding and thrombolization 1 Fuwai Hospital Causes of 4 death during followup 1: male, 49 yrs, died of Cerebral Hemorrhage 30 months postop 2: male, 47 yrs, died 15 days postop with unkown reason 3: female, 58 yrs, died of Leukemia 24 months postop 4: female, 56 yrs, died of heart failure 12 months postop Fuwai Hospital time I II III IV PRE 0 0 20 14 POST 27 4 3 0 COMPARATION OF CAR