Nguyen Huu Uoc
Nationality
Vietnam
Current Position
Surgeon, MD, PhD Director of Center
Organization
Cardiovascular and thoracic Center, Viet-Duc university hospital
Abdominal Aorta & Aortic iliac Session

Topic: Ten years experiences of hybrid procedure for the thoracic aortic disease at Viet-Duc university hospital

Abstract

Overview: Thoracic aortic pathology has increased rapidly in Vietnam in recent years, both in number and complexity, especially lesions in the aortic arch region. Although there are more modern interventions in the world (chimney, stents with branches, fenestration), the hybrid procedure is focused on developing more strongly - especially in surgical facilities, at Viet-Duc university hospital (VDUH) since 10 years, by the lower cost and surgical vascular competence. Methods: Retrospective descriptive study all cases of thoracic aortic pathology, treated with hybrid procedure at cardiovascular and thoracic Center – VDUH, from March 2012 to August 2022. Result: There are 170 cases with 140 males (82.7%), 57 cases performed in emergency, very complicated basically disease with hypertension (80%) - smoking and fat metabolism disorders (69.4%) - multiple artery pathologies (24.1%). Aortic pathology includes: type B dissection (79), aortic arch aneurysm (45), descending thoracic aneurysm (24), aortic injury (15), intramural hematoma - ulcer (7). Do not count more than 50 cases of FET procedure in the last 4 years. Simultaneous vascular surgery is composed of: carotid-carotid bypass (72), revascularization of left sub-clavicular or vertebral arteries bypass (55), ascending aorta to the neck arteries bypass (34), replace ascending aorta + neck arteries bypass (9). Early results: technical success (100%), no leakage and re-endovascular intervention, low complication rate: 3 surgical complications, 3 stroke - paralysis, 2 renal failure, 1 AMI. Average recovery time in 5 days, average hospitalization of 25 days, mortality in 30 days is only 7%. Conclusion: Hybrid is a suitable method for complex aortic pathologies in Vietnam conditions in the last ten years, the technique is not too complicated and the safety is high. To develop this technique well, there should be a strong vascular surgical unit and good intervention – surgery cooperation.

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