Perioperative and long-term outcome after ascending aortic and arch repair with elephant trunk and open thoracoabdominal aortic aneurysm repair
| Autor: | Michael J. Jacobs, Ann-Kathrin Hundertmark, Mohammad E. Barbati, Shirley Ketting, Geert Willem H. Schurink, Alexander Gombert, Barend Mees, Federico Pedersoli, Paula R. Keschenau, Drosos Kotelis, Marcia Viviane Rückbeil |
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| Přispěvatelé: | RS: Carim - V03 Regenerative and reconstructive medicine vascular disease, Vascular Surgery, MUMC+: MA Vaatchirurgie CVC (3), MUMC+: MA Med Staf Spec Vaatchirurgie (9), MUMC+: *HVC European Venous Centre (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Aortic arch
Adult Male medicine.medical_specialty Time Factors Elephant trunks SURGERY Aorta Thoracic GUIDELINES DEFINITIONS Aortic aneurysm Blood Vessel Prosthesis Implantation Postoperative Complications medicine.artery Germany Ascending aorta medicine Humans Frozen elephant trunk Survival rate DISSECTION Netherlands Retrospective Studies Acute aortic syndrome Aortic Aneurysm Thoracic SEPSIS business.industry Mortality rate MORTALITY Endovascular Procedures FET Perioperative Middle Aged medicine.disease EDITORS CHOICE Surgery TAAA TIME Treatment Outcome Female Cardiology and Cardiovascular Medicine business Thoracoabdominal aortic aneurysm |
| Zdroj: | Journal of Vascular Surgery, 75(3), 824-832. MOSBY-ELSEVIER |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2021.09.026 |
| Popis: | OBJECTIVE: To describe the outcome of open thoracoabdominal aortic aneurysm (TAAA) repair following previous aortic arch repair including elephant trunk (ET) or frozen elephant trunk (FET) for acute and chronic pathologies.METHODS: This was a retrospective, observational, multicenter study including 32 patients treated between 2006 and 2019 in two aortic centers using identical surgical protocols. Assessment focused on perioperative and long-term outcome, namely in-hospital morbidity and mortality, as well as procedure-related reintervention rate and aortic-related mortality rate. Kaplan-Meier curves with 95% confidence intervals were used to analyze the overall survival after surgery within the cohort.RESULTS: Thirty-two patients (mean age, 45.0 ± 13.6 years; 20 males [62.5%]) were treated because of acute (34.38% [n = 11]) or chronic (65.62% [n = 21]) aortic pathologies, including residual dissection following acute, symptomatic type A dissection (n = 7) and symptomatic mega aortic syndrome (n = 4), as well as post-dissection TAAA (n = 18) and asymptomatic mega aortic syndrome (n = 3). Twenty-eight patients (87.5%) received type II repair, and 4 patients (12.5%) received type III repair after previous ascending aorta and arch repair including ET/FET. Concomitant infrarenal and iliac vessel repair was performed in 38.7% (n = 12) and 29.4% (n = 10), respectively. The in-hospital mortality rate was 18.75% (n = 6). Spinal cord ischemia occurred in two cases, both after one-stage emergency procedure with one case of permanent paraplegia. Temporary acute kidney injury occurred in 41.94% (n = 13). The estimated 1-year survival rate was 78.1% (95% confidence interval, 63.9%-95.6%), with a median follow-up time of 1.29 years (interquartile range, 0.26-3.88 years). No procedure-related reinterventions and one case of aortic-related mortality, namely sepsis because of graft infection, was observed.CONCLUSIONS: Open TAAA repair following aortic arch repair including ET or FET because of acute or chronic aortic pathologies is associated with a relevant perioperative morbidity and mortality rate. During follow-up, a low aortic-related mortality rate and procedure-related reintervention rate were observed. |
| Databáze: | OpenAIRE |
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