Document Detail

Long-term results of second-stage thoracic endovascular aortic repair following total aortic arch replacement.
MedLine Citation:
PMID:  20941562     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We investigated the surgical results of secondary thoracic endovascular aneurysm repair (TEVAR) using the elephant trunk graft after total aortic arch replacement (TAR) for extensive thoracic aortic lesions.
METHODS: The subjects comprised 16 patients who underwent TEVAR as a staged procedure following TAR at our institution between 1997 and 2007. Long-term results were retrospectively surveyed (mean observation period 68.4 months). We performed TEVAR with the elephant trunk graft as a proximal landing zone for the descending thoracic repair, the mean duration between TAR and TEVAR was 4.7 weeks for the staged operations and 18.3 months for the nonstaged operations.
RESULTS: Early results were good in all cases, with no deaths and no noteworthy complications. For the seven patients without dissection, long-term results were also good. Among the nine patients with dissection, the false lumen in the thoracoabdominal area enlarged in three during follow-up. We performed thoracoabdominal repair in two, but one died of an aneurysm-esophageal fistula. There was only one long-term aneurysm-related death.
CONCLUSION: Second-stage TEVAR using the elephant trunk graft after TAR allows less invasive surgery for extensive aortic lesions and achieves good long-term results. However, enlargement of the false lumen was a long-term concern in patients with aortic dissection, and careful follow-up is essential.
Yukio Obitsu; Nobusato Koizumi; Yasunori Iida; Toru Iwahashi; Naozumi Saiki; Yoshiko Watanabe; Hisahito Takae; Satoshi Kawaguchi; Hiroshi Shigematsu
Publication Detail:
Type:  Journal Article     Date:  2010-10-13
Journal Detail:
Title:  General thoracic and cardiovascular surgery     Volume:  58     ISSN:  1863-6713     ISO Abbreviation:  Gen Thorac Cardiovasc Surg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-13     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101303952     Medline TA:  Gen Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  501-5     Citation Subset:  IM    
Department of Vascular Surgery, Tokyo Medical University, Shinjyuku-ku, Japan.
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MeSH Terms
Aneurysm, Dissecting / mortality,  radiography,  surgery*
Aorta, Thoracic / radiography,  surgery*
Aortic Aneurysm, Thoracic / mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation,  mortality
Endovascular Procedures* / adverse effects,  instrumentation,  mortality
Prosthesis Design
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Treatment Outcome

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

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