Document Detail


Long-term outcomes after entry closure and aneurysmal wall plication for type B aortic dissection.
MedLine Citation:
PMID:  18162405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the long-term outcomes after entry closure and aneurysmal wall plication for type B chronic dissecting aortic aneurysm. This procedure uses no artificial graft and preserves all intercostal arteries. METHODS: We reviewed the records of 40 consecutive patients who underwent this procedure between September 1983 and December 2002. The mean age at operation was 60+/-12 years (range, 38-79 years). The mean follow-up period was 9.8+/-5.1 years (range, 4-23 years). Follow-up was completed in 38 patients (95%). The latest computed tomography scans (n=22) were obtained 9.5+/-5.1 years (range, 3-18 years) after surgery. RESULTS: There were no operative deaths and 14 late deaths, none of which were related to the aneurysm. No paraplegia or paraparesis occurred. The survival rate was 92+/-4% at 5 years and 64+/-9% at 10 years; 24 patients are still alive. Follow-up computed tomography revealed that the mean diameter of the plicated descending aorta was 31+/-5mm (range, 22-39 mm) except in four patients. One of the four patients required reoperation for recurrent aneurysm of the plicated aorta 3 years postoperatively. In the remaining three patients, the plicated aorta has become enlarged; however, these patients have not yet undergone reoperation. Reoperation for residual dissecting aneurysm was performed in another three patients whose plicated aorta was normal. Freedom from reoperation for residual dissecting aneurysm was 78+/-5% at 10 years. CONCLUSIONS: This procedure produces excellent short-term outcomes and low long-term morbidity. It could be the procedure of choice in selected patients to prevent paraplegia, although graft replacement is currently the standard treatment for chronic aortic dissecting aneurysm.
Authors:
Yuji Miyamoto; Toshihiro Ohata; Masataka Mitsuno; Mitsuhiro Yamamura; Hiroe Tanaka; Yasuhiko Kobayashi; Masaaki Ryomoto; Shinya Fukui
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-12-26
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  33     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-21     Completed Date:  2008-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  152-6     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. y-miyamo@hyo-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Dissecting / surgery*,  ultrasonography
Aortic Aneurysm, Thoracic / surgery*,  ultrasonography
Chronic Disease
Dilatation, Pathologic / surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Recurrence
Reoperation / statistics & numerical data
Survival Analysis
Suture Techniques
Treatment Outcome
Vascular Surgical Procedures / methods*

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


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