«Debranching aortique» chez les patients contre-indiqués à la chirurgie classique : cohorte de 32 patients
| Autor: | Aguettant, Antoine, Metras, Alexandre, Pernot, Mathieu, Watanabee, M, Oses, Pierre, Peltan, Julien, Laborde, Marie-Nadine, Madonna, Francesco, Cadusseau, L, Fresselinat, Aurélie, Barandon, Laurent, Labrousse, Louis |
|---|---|
| Rok vydání: | 2018 |
| Předmět: | |
| DOI: | 10.24399/jctcv22-3-agu |
| Popis: | JCTCV:22(3) Introduction: The first-line treatment of transverse aortic aneurysms is open surgery with circulatory arrest. The increase in endovascular surgery allows new forms of management. This retrospective study investigated the feasibility and reliability of a hybrid procedure, endoprosthetic aortic treatment associated with surgical revascularization of supra-aortic trunks. Methods: We selected all patients operated on for a thoracic aortic stent between 2000 and 2014. We retrospectively included 32 patients who underwent endovascular aortic arch surgery with surgical revascularization of the supra-aortic trunks. We excluded isolated revascularizations of the left subclavian artery. The primary endpoint was surgical success defined by exclusion of the aneurysm with no type I endoleak following surgery. The secondary endpoints were postoperative stroke incidence, 30-day survival, 2-year survival, and no reoperation. Patient follow-up was carried out by a scanner prior to hospital discharge, and a CT scan 6 months and 1 year later, and then every year. Results: Surgical success was achieved in 94% of cases. Only 2 patients had a type I endoleak postoperatively. The incidence of stroke postoperatively was 3% (n = 1). The 30-day mortality was 9% (n = 3). The causes of death were heart failure (n = 2) and multiorgan failure (n = 1). It should be noted that these 3 patients were hospitalized for emergency aneurysm cracking. The absence of re-intervention was 91% at 1 year and 84% at 5 years. Survival at 2 years was 62%. Conclusion: The feasibility of aortic debranching in the treatment of transverse aortic aneurysms is comparable to fully endovascular procedures, and it has lower morbidity and mortality than open surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|