Debranching thoracic endovascular aortic repair for distal aortic arch aneurysm in elderly patients aged over 75 years old

Autor: Tomohiro Kurashiki, Yuki Otsuki, Suguru Shiraya, Takeshi Onohara, Yuichiro Kishimoto, Yoshinobu Nakamura, Hiromu Horie, Motonobu Nishimura, Shingo Harada
Rok vydání: 2019
Předmět:
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Debranching TEVAR
Distal arch aneurysm
lcsh:Surgery
Thoracic aortic aneurysm in the elderly
lcsh:RD78.3-87.3
chemistry.chemical_compound
Blood Vessel Prosthesis Implantation
Postoperative Complications
Diabetes mellitus
medicine
Humans
Hospital Mortality
Aged
Retrospective Studies
Aged
80 and over
Creatinine
Ejection fraction
Aortic Aneurysm
Thoracic
Cerebral infarction
business.industry
Incidence (epidemiology)
Endovascular Procedures
General Medicine
Aortic arch aneurysm
lcsh:RD1-811
Cerebral Infarction
Length of Stay
medicine.disease
Progression-Free Survival
Cardiac surgery
Surgery
Aortic Aneurysm
Survival Rate
Intensive Care Units
Treatment Outcome
chemistry
Cardiothoracic surgery
lcsh:Anesthesiology
Case-Control Studies
Female
Cardiology and Cardiovascular Medicine
business
Research Article
Zdroj: Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery, Vol 15, Iss 1, Pp 1-7 (2020)
Shiraya Suguru, Nakamura Yoshinobu, Harada Shingo, et al. Debranching thoracic endovascular aortic repair for distal aortic arch aneurysm in elderly patients aged over 75 years old. JOURNAL OF CARDIOTHORACIC SURGERY. 2020. 15(1). doi:10.1186/s13019-020-10
ISSN: 1749-8090
DOI: 10.1186/s13019-020-10
Popis: Background We examined the outcome of debranching thoracic endovascular aortic repair (d-TEVAR) without sternotomy for distal aortic arch aneurysm in patients aged ≥75 years. Methods Patients who underwent d-TEVAR or TAR for aortic arch aneurysm between 2008 and 2015 at our hospital and aged ≥75 years were included. Age, sex, left ventricular ejection fraction, preoperative creatinine level, diabetes, cerebrovascular disease, and chronic obstructive pulmonary disease were matched using PS. Results Among 74 patients (d-TEVAR: 51, TAR: 23), 17 patients in each group were matched. No difference in surgical outcome was detected between the d-TEVAR and TAR groups, including 30-day death (0% vs. 0%), hospital death (5.8% vs. 0%: p = 0.31) and incidence of cerebral infarction (5.8% vs. 7.6%: p = 0.27) as well as the long-term outcomes of 5-year survival (92.8% vs. 74.8%: p = 0.30) and 5-year aorta-related event-free rate (88.2% vs. 100%: p = 0.15). Average duration of ICU stay (1.3 ± 1.1 days vs. 5.6 ± 1.3 days: p = 0.025) and hospital stay (16.5 ± 5.2 days vs. 37.7 ± 19.6 days: p = 0.017) were significantly shorter in the d-TEVAR group. Conclusion Our results indicated that d-TEVAR is less invasive without affecting long-term outcome up to 5 years. Although the number of the patients included in the study was small, debranching TEVAR could be one of the treatments of the choice in the elderly, especially with comorbidities.
Databáze: OpenAIRE
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