Neurologic Outcomes in Aortic Arch Repair With Frozen Elephant Trunk Versus 2-Stage Hybrid Repair
| Autor: | George J. Arnaoutakis, Ahmed I.M. Ismail, Thomas M. Beaver, Aly M. Abdel-Wahab, Tomas D. Martin, Seyed Hossein Aalaei-Andabili, Mahmoud Alhussaini, Mohamed A.K. Salama Ayyad |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Aortic arch medicine.medical_specialty Elephant trunks Aorta Thoracic 030204 cardiovascular system & hematology Blood Vessel Prosthesis Implantation 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine.artery medicine Humans Stage (cooking) Arch Survival rate Aged Retrospective Studies Aorta business.industry Retrospective cohort study Middle Aged Surgery 030228 respiratory system Cardiothoracic surgery Female Nervous System Diseases Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 107:1775-1781 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2018.11.042 |
| Popis: | We compared outcomes of single-stage hybrid aortic arch replacement (frozen elephant trunk) versus 2-stage hybrid repairs with primary open arch procedures followed by thoracic endovascular stenting.This study reports a single-center retrospective review (2003 to 2016) of 118 patients undergoing hybrid repair of the aortic arch including 48 single-stage repairs versus 70 two-stage repairs.Single-stage repair was performed in 48 patients, including 31 (64.6%) men and 17 (35.4%) women with a mean age of 64 ± 11 years and a 2-stage procedure was performed in 70 patients, including 42 (60%) men and 28 (40%) women with a mean age of 65.67 ± 13.3 years (p = 0.46). More emergent single-stage procedures were performed in 23 of 48 (47.9%) patients versus 2-stage procedures in 8 of 70 (11.43%) patients (p0.001). Between the single- and 2-stage groups, there was no difference in stroke (6.25% [3 of 48] versus 14.28% [10 of 70]; p = 0.23), spinal cord ischemia (4.16% [2 of 48] versus 5.7% [4 of 70]; p = 1.0), or 30-day mortality rate: 8 of 48 (16.7%) patients versus a combined 30-day mortality rate of the 2-stage procedure of 14.8% (4 of 70 [5.7%] at the first stage and 5 of 55 [9.1%] at the second stage; p = 0.56), respectively. After exclusion of the 30-day mortality, midterm survival was 86% at 1 to 2 years for single-stage patients versus 80% at 1 year and 46% at 2 years for the 2-stage patients (p = 0.0019).Both single-stage and 2-stage hybrid arch replacements are effective approaches for treating complex aortic arch diseases. Early deaths and neurological outcomes in the single-stage group are comparable to those in the combined 2-stage group. Furthermore, in this series, patients who had a single-stage hybrid procedure had a higher survival rate at 2 years. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|