Document Detail


Mid-term results of thoracic endovascular aortic repair in surgical high-risk patients.
MedLine Citation:
PMID:  19359283     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between May 2001 and June 2008, the outcome and morphological changes in thoracic aortic lesions of 20 surgical high-risk patients who underwent TEVAR were evaluated. Aortic lesions included 8 (40%) type B dissections, 5 (25%) atherosclerotic aneurysms, 4 (20%) penetrating ulcers and 3 (15%) traumatic aortic ruptures. All patients were classified as American Society of Anaesthesiologists class IV and obtained high scores in both the logistic European System for Cardiac Operative Risk Evaluation, median of 14.5% (range 8.1-65.7%), and the STS Parsonet 95 scoring system, median of 14 (range 10-52). Endovascular stent-graft deployment was technically successful in all cases. No surgical conversion occurred. Early mortality was observed in two patients. Clinical and imaging follow-up was available in all patients at a median time of 28 months (range 4-89 months). Overall actuarial survival was 90% at one and five years and 60% at seven years. Mean diameter of the descending aorta decreased from 51.1+/-13 mm to 45.3+/-8 mm (P=0.032). Mean reduction in dimension of aneurysms was 10.7+/-8 mm. Endovascular thoracic aorta repair will probably benefit more patients with multiple comorbidities that limit their life expectancy than patients with a lower profile.
Authors:
Victor X Mosquera; José M Herrera; Milagros Marini; Francisco Estevez; Ignacio Cao; Daniel Gulías; José V Valle; José J Cuenca
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Publication Detail:
Type:  Journal Article     Date:  2009-04-09
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-23     Completed Date:  2009-08-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  61-5     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Juan Canalejo Hospital, La Coruña, Spain. vxmr@canalejo.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, Dissecting / surgery
Angiography, Digital Subtraction
Aorta, Thoracic / injuries,  radiography,  surgery*
Aortic Aneurysm, Thoracic / surgery
Aortic Diseases / mortality,  radiography,  surgery*
Aortography / methods
Atherosclerosis / surgery
Blood Vessel Prosthesis Implantation* / adverse effects,  mortality
Female
Humans
Kaplan-Meiers Estimate
Magnetic Resonance Angiography
Male
Middle Aged
Patient Selection
Risk Assessment
Severity of Illness Index
Time Factors
Tomography, Spiral Computed
Treatment Outcome
Ulcer / surgery
Wounds, Penetrating / surgery

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


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