Descending thoracic aortic repair outcomes for chronic aortic dissection: a single-centre experience
| Autor: | Yoshitaka Yamane, Susumu Oshima, Kazumasa Ishiko, Makoto Okiyama, Tomohiro Hirokami, Yuki Hirai, Shigeru Sakurai, Kensuke Ozaki, Kenichi Yoshimura, Shinya Takahashi, Shin Yamamoto |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
Time Factors Aortic Aneurysm Thoracic Endovascular Procedures Aorta Thoracic Kaplan-Meier Estimate Middle Aged Aortic Dissection Blood Vessel Prosthesis Implantation Treatment Outcome Risk Factors Humans Surgery Cardiology and Cardiovascular Medicine Spinal Cord Injuries Aged Retrospective Studies |
| Zdroj: | Interactive cardiovascular and thoracic surgery. 35(4) |
| ISSN: | 1569-9285 |
| Popis: | OBJECTIVES Thoracic endovascular aortic repair is a widely accepted treatment for chronic aortic dissection because of good early results compared to open surgical repair. We provide early and long-term results of descending thoracic aortic repair for chronic aortic dissection. METHODS Patients who underwent descending thoracic aortic repair for chronic aortic dissection between January 2012 and December 2020 at Kawasaki Aortic Centre were included in this analysis. RESULTS Four hundred ninety-two patients (median age, 64 years; interquartile range, 52–75 years) were included. The median duration of follow-up was 3.2 years (interquartile range, 1.5–5.2 years). The early mortality rate was 2.0% (n = 10); strokes occurred in 17 patients (3.5%); and spinal cord injuries occurred in 30 patients (6.1%). Early major adverse events including early death, stroke, spinal cord injury, tracheostomy and haemodialysis at the time of discharge occurred in 62 patients. Multivariable analysis indicated that age > 70 years and non-elective surgery were predictors of early major adverse events. Among patients without both risk factors (i.e. low-risk patients), 1 early death (0.4%), 3 strokes (1.5%) and 1 spinal cord injury (0.4%) were observed, 2 tracheostomies were performed (0.8%) and no patients required haemodialysis at the time of hospital discharge. The 5-year survival rate was 87.2%. The cumulative incidence of chronic aortic dissection-related aortic reintervention at 5 years was 7.9%. CONCLUSIONS Descending thoracic aortic repair for chronic aortic dissection resulted in good early and long-term results, and it can serve as the gold standard for low-risk patients. |
| Databáze: | OpenAIRE |
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