One-Stage Hybrid Total Aortic Arch and Descending Thoracic Aortic Repair is a Safe and Secure Procedure With Less Postoperative Complications for Extended Aortic Arch Aneurysms
| Autor: | Hirokuni Arai, Masashi Takeshita, Tsuyoshi Hachimaru, Yushi Okumura, Masafumi Yashima, Kiyotoshi Oishi, Eiki Nagaoka, Tatsuki Fujiwara, Keiji Oi, Tomohiro Mizuno |
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| Rok vydání: | 2021 |
| Předmět: |
Aortic arch
2019-20 coronavirus outbreak medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Aorta Thoracic Aortic repair Blood Vessel Prosthesis Implantation Postoperative Complications Risk Factors medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Thoracic aortic disease Retrospective Studies Aortic Aneurysm Thoracic business.industry Endovascular Procedures One stage Aortic arch aneurysm Surgery Treatment Outcome Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Endovascular Therapy. 29:204-214 |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1177/15266028211047954 |
| Popis: | Purpose Hybrid aortic arch repair (HAR) has been implemented for extended aortic arch and descending thoracic aortic disease since 2012 in our institution. This study aimed to estimate the early and mid-term efficacy and safety of HAR. Materials and Methods From 2007 to 2019, 56 patients underwent HAR for extended aortic arch disease, and 75 patients underwent total arch replacement (TAR) for arch-limited disease. HAR comprises 3 procedures: replacement of the aorta, reconstruction of all arch vessels, and thoracic endovascular aortic repair (TEVAR) from zone 0 to the descending aorta after cardiopulmonary bypass is off in 1 stage. The type II-1 HAR procedure, in which the ascending aorta and aortic arch distal to the brachiocephalic artery are replaced, was the most frequently selected procedure (40/56 patients). The outcomes of the type II-1 HAR procedure were compared with those of TAR using the Cox regression analysis. Results The median follow-up period was 36 months. In HAR, the operative mortality, in-hospital mortality, and postoperative permanent neurological deficits were not observed. The paraplegia rate was 1.8%. TEVAR-related complications occurred in 3 patients. Among the patients with non-ruptured atherosclerotic aortic arch aneurysm (31 type II-1 HAR patients and 36 TAR patients, the postoperative respiratory support time in those who underwent type II-1 HAR was quicker than in those who underwent TAR (pConclusions HAR, especially the type II-1 procedure, can treat extended aortic arch disease with acceptable survival outcomes. The development of TEVAR technology will further improve the outcomes of HAR in the future. |
| Databáze: | OpenAIRE |
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