One-Year Follow-Up After Hybrid Thoracoabdominal Aortic Repair: Potentially Important Issue for Preoperative Decision-Making
| Autor: | Sander Ten Raa, Robert Jan Stolker, Hence J.M. Verhagen, Sanne E. Hoeks, Rob A. van de Graaf, Frank Grüne, Felix van Lier |
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| Přispěvatelé: | Anesthesiology, Surgery |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Pathology One year follow up business.industry Medical record Retrospective cohort study General Medicine Perioperative 030204 cardiovascular system & hematology Vascular surgery medicine.disease Aortic repair Surgery 03 medical and health sciences Aortic aneurysm 0302 clinical medicine medicine 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Cause of death |
| Zdroj: | Vascular and Endovascular Surgery, 51(1), 23-27. SAGE Publishing |
| ISSN: | 1538-5744 |
| DOI: | 10.1177/1538574416683755 |
| Popis: | Background: Compared to open thoracoabdominal aortic aneurysm (TAAA) repair, hybrid repair is thought to be less invasive with better perioperative outcomes. Due to the extent of the operation and long recovery period, studying perioperative results may not be sufficient for evaluation of the true treatment effect. The aim of this study is to evaluate 1-year mortality and morbidity in patients with TAAA undergoing hybrid repair. Methods: In a retrospective cohort study, all medical records of patients undergoing hybrid repair for TAAA at the Erasmus University Medical Center between January 2007 and January 2015 were studied. Primary outcome measures were 30-day and 1-year mortality. Secondary outcome measures included major in-hospital postoperative complications. Results: A total of 15 patients were included. All-cause mortality was 33% (5 of the 15) at 30 days and 60% (9 of the 15) at 1 year. Aneurysm-related mortality was 33% (5 of the 15) and 53% (8 of the 15) at 30-day and 1-year follow-up, respectively, with colon ischemia being the most common cause of death. Major complication rate was high: myocardial infarction in 2 (13%) cases, acute kidney failure in 5 (33%) cases, bowel ischemia in 3 (20%) cases, and spinal cord ischemia in 1 (7%) case. Conclusion: The presumed less invasive nature of hybrid TAAA repair does not seem to result in lower complication rates. The high mortality rate at 30 days continues to rise dramatically thereafter, suggesting that 1-year mortality is a more useful clinical parameter to use in preoperative decision-making for this kind of repair. |
| Databáze: | OpenAIRE |
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