|Long-term results of the open stent-grafting technique for extended aortic arch disease.|
|PMID: 18544367 Owner: NLM Status: MEDLINE|
|OBJECTIVE: This report elucidates the long-term safety and effectiveness of extended aortic arch replacement with an open stent-grafting technique from our 12 years of experience. METHODS: From 1994 to 2004, 126 patients (mean age 67.8 years) with different pathologic conditions of the aortic arch with extension to the descending aorta (57 dissections [acute/chronic = 31/26] and 69 aneurysms) were operated on with an open stent-grafting technique. During deep hypothermic circulatory arrest with selective cerebral perfusion, the stent graft was delivered through the transected proximal aortic arch, and arch replacement with a 4-branched prosthesis was performed. RESULTS: Operative mortality within 30 days was 3.2%. Perioperative morbidity included 7 (5.6%) strokes and 8 (6.3%) spinal injuries (paraplegia in 3, transient paraparesis in 5). Sixty-three percent of the patients were extubated within 24 hours. In long-term follow-up (mean 60.4 +/- 36.5 months, maximum 153 months), survival was 81.1%, 63.3%, and 53.7% at 1, 5, and 8 years. Five (3.9%) late endoleaks were observed but treated with successful additional endovascular repair. Freedom from endoleaks was 98.0%, 91.1%, and 91.1% for 1, 5, and 8 years, respectively. CONCLUSION: Long-term observation showed safety and good durability of the open stent-grafting technique for aortic arch disease. This technique could be an attractive treatment option for aortic arch aneurysm with distal extension and aortic dissection requiring aortic arch replacement.|
|Kazuo Shimamura; Toru Kuratani; Goro Matsumiya; Masaaki Kato; Yukitoshi Shirakawa; Hiroshi Takano; Noriyuki Ohta; Yoshiki Sawa|
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|Type: Journal Article|
|Title: The Journal of thoracic and cardiovascular surgery Volume: 135 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2008 Jun|
|Created Date: 2008-06-11 Completed Date: 2008-07-15 Revised Date: -|
Medline Journal Info:
|Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States|
|Languages: eng Pagination: 1261-9 Citation Subset: AIM; IM|
|Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Aneurysm, Dissecting / mortality, radiography, surgery*
Angiography / methods
Angioplasty / methods*, mortality
Aorta, Thoracic / physiopathology, surgery*
Aortic Aneurysm, Thoracic / mortality, radiography, surgery*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / methods*, mortality
Postoperative Complications / mortality
Severity of Illness Index
Sternum / surgery
Thoracotomy / methods*
Tomography, X-Ray Computed / methods
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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