Document Detail


Long-term results of the open stent-grafting technique for extended aortic arch disease.
MedLine Citation:
PMID:  18544367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kazuo Shimamura; Toru Kuratani; Goro Matsumiya; Masaaki Kato; Yukitoshi Shirakawa; Hiroshi Takano; Noriyuki Ohta; Yoshiki Sawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  135     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Jun 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  1261-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
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
Cohort Studies
Echocardiography, Doppler
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications / mortality
Prosthesis Design
Prosthesis Failure
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sternum / surgery
Survival Analysis
Thoracotomy / methods*
Time Factors
Tomography, X-Ray Computed / methods
Treatment Outcome

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


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