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ﺳﻪشنبه, 23 شهریور,1400

عمل جراحي TEVAR+FL occlusion with ASD device در بيمار با

دايسكشن تايپ A كه قبلا عمل بنتال + Aortic arch replacement and debranching شده بود.


CTA Patient :

*Patient History* (According to patient) 
Patient is hospitalized at Afshar hospital 
patient has abdomen  and chest pain
shortness in breathing
history of bental, aortic arch replacement & aortic arch debranching by Dr Foroozan nia 3 years ago 
History of kidney stone
borderline hypertensive
Cr: 1
Age: 58

*Anatomical Measurements* (According to CTA dated: 9 Sept 2021, Salar sizing date: 11 Sept 2021)
Tri-lumen TBD starting distal to the LSA, 
9cm dilatation in the aortic isthmus 
pleural effusion in the left side 
TL compressed to less than 5mm in the inferior descending thoracic aorta
SMA and L renal artery perfused from the TL
celiac and R renal artery perfused from the FL 
several large entry tears noted in the visceral aorta
dissection extends to the infra-renal aorta
inferior abdominal aorta and iliacs are healthy 

*Proposed Treatment Strategy*
a TEVAR plan was arranged for the patient back in 2018, but was aborted even after the patient purchased the devices
Therefore, emergent TEVAR is recommended, from the dacron arch graft in Zone 2 up to the celiac trunk with two devices
Also, we should consider placing an ASD device in the FL in the inferior descending thoracic aorta in order to occlude the FL and prevent retrograde perfusion of the FL 

*Procedural complexity* 
Low peri-procedural technical risk 

The plan based on the available data is to be taken in the context of a suggestion only. The confirmation of the measurements and the decision as to whether to proceed with this plan in whole, in part, or not at all, rests with the physician.


عمل جراحي TEVAR + FL occlusion with ASD device

گروه خبری : اخبار روز
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