1. Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China
Management of Aortic Dissection----New classification and Mid-term results
Dinghua Yi, et al
Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China
Dear president,
Good morning, ladies and gentlemen. It’s my great honor to be here, in scottsdale, to share our experience with everybody. Today my topic is ***.

2. Zones based on hybrid procedure
As we all know,
Criado Zonation， 2005 (According to stent graft, suitable for aneurysm)
Xijing Classification, 2006 （According to primary tear, suitable for dissection ）

3. Zone 1
Zone 4
Zone 3
Zone 4

4. Materials and Methods From December 2001 to June 2009
525 patients (492 male, 33 female)
The average age of 49.2 years old (37 ~ 73)
Acute dissection
Chronic dissection
From

5. 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.)

6. Frozen elephant trunk technique was applied in patients with multiple tears (Zone 1 +Zone 2,3,4)

7. Ascending aorta to bilateral common carotid artery bypass should be established before endovascular exclusion for primary tears in Zone 2.

8. Bilateral common carotid artery bypass should be established before endovascular exclusion for primary tears located in the Zone 3.

9. TEVAR became the gold standard for dissection with primary tears in Zone 4

10. Results Mortality Rate Complications Procedure related 6.7%
Heart failure
Renal failure
Cerebral insufficiency
Infection
Endoleak
Hepatic insufficiency
Iatrogenic dissection
6.7%
3.3%
2.1%
1.1%
0.6%
0.6%
0.4%
0.4%

11. Zone 1：Ascending Aorta Replacement
Discussion
Defining zones according to the tear location is useful for planning a hybrid approach
Zone 2：Ascending aorta Bypass +TEVAR
Zone 3：Carotid Bypass+TEVAR
Zone 1：Ascending Aorta Replacement
Zone 4: TEVAR 11

12. Publications
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