Document Detail


Clinical outcomes of different approaches to aortic arch disease.
MedLine Citation:
PMID:  25095745     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to evaluate the midterm clinical outcomes of various approaches, including hybrid procedures, to aortic arch pathologies.
METHODS: Of 305 consecutive patients who underwent aortic arch repair between 2005 and 2013, 244 underwent conventional open total aortic arch repair (CTAR) with antegrade cerebral perfusion under circulatory arrest, 35 underwent debranching of the arch with thoracic endovascular aortic repair (DTEVAR), and 26 underwent staged TEVAR after TAR with elephant trunk (TARET). We retrospectively evaluated the outcomes of the three groups.
RESULTS: The DTEVAR group had a greater percentage of patients with preoperative comorbidities. Significant differences were observed in 30-day mortality (DTEVAR, 14.3% [5 of 35] vs TARET TEVAR, 0% [0 of 26] vs CTAR, 5.3% [13 of 244]; P = .045) and stroke (DTEVAR, 28.6% [10 of 35] vs TARET TEVAR, 7.7% [2 of 26] vs CTAR, 8.2% [20 of 244]; P = .001). In overall midterm survival, the DTEVAR group had a lower survival rate (63.9% 3-year survival) compared with the CTAR (90.1% 7-year survival) and the TARET TEVAR (95.5% 2.5-year survival) groups. In elective cases, better midterm results were observed in CTAR and TARET TEVAR groups. An increased number of debranching graft and emergency operations resulted in a much lower follow-up survival rate in the DTEVAR group. Atherosclerotic disease had a great effect on midterm outcomes in the DTEVAR (P = .045) and CTAR groups (P = .002).
CONCLUSIONS: The clinical feasibility of DTEVAR for high-risk patients requiring zone 0 landing or emergency surgery is still controversial. Atherosclerotic disease of the aorta has a significant negative effect on midterm outcomes in any surgical approach.
Authors:
Arudo Hiraoka; Genta Chikazawa; Kentaro Tamura; Toshinori Totsugawa; Taichi Sakaguchi; Hidenori Yoshitaka
Related Documents :
12665995 - Influence of two different volume replacement regimens on renal function in elderly pat...
23109095 - A non-randomized controlled clinical trial on autologous chondrocyte implantation (aci)...
24384665 - Pulmonary function improvement after vertebral column resection for severe spinal defor...
23464955 - Clavicular length: the assumption of symmetry.
17635395 - The kinetics of ringer's solution in young and elderly patients during induction of gen...
22581925 - Higher volume endovascular stroke centers have faster times to treatment, higher reperf...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-2
Journal Detail:
Title:  Journal of vascular surgery     Volume:  -     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Imaging of the Muscle-Bone Relationship.
Next Document:  Association of monocyte tumor necrosis factor ? expression and serum inflammatory biomarkers with wa...