Document Detail

Midterm results of endovascular treatment of complicated acute type B aortic dissection.
MedLine Citation:
PMID:  19698847     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The operative mortality and morbidity of patients with complicated acute type B aortic dissection remain high. The endovascular approach has been proposed as a potential alternative. The purpose of this study is to review the contemporary outcome of patients undergoing endovascular treatment for complicated acute type B aortic dissection. METHODS: A retrospective analysis of 28 patients undergoing endovascular interventions for acute type B aortic dissection was performed. Kaplan-Meier survival analysis was used for statistical computation. RESULTS: Indications for emergency endografting were rupture in 4 (14%) patients, severe lower body malperfusion in 8 (29%) patients, visceral/renal malperfusion in 7 (25%) patients, persistent chest pain despite proper anti-impulsive therapy in 5 (18%) patients, uncontrollable hypertension in 1 (4%) patient, and acute dilatation of false lumen with impending rupture in 3 (11%) patients. Three (11%) patients died early. Three patients died during follow-up of non-aorta-related causes. Overall survival was 82% and 78% at 1 and 5 years' follow-up, respectively. The aorta-related mortality was 10% for the entire follow-up period. Complete thrombosis of the false lumen in the thoracic aorta was achieved in 22 (85%) members of the surviving cohort, and partial thrombosis was achieved in the remainder. The rate of treatment failure according to Stanford criteria was 18% at 5 years. Mean follow-up was 36 months, and follow-up was complete in 28 (100%) patients. CONCLUSIONS: Thoracic aortic endografting for complicated acute type B aortic dissection can be performed with a relatively low postoperative morbidity and mortality in experienced hands. The endovascular approach to life-threatening complications of acute type B aortic dissection appears to have a favorable outcome in midterm follow-up.
Ali Khoynezhad; Carlos E Donayre; Bassam O Omari; George E Kopchok; Irwin Walot; Rodney A White
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  138     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-24     Completed Date:  2009-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  625-31     Citation Subset:  AIM; IM    
Division of Cardiothoracic and Vascular Surgery, Creighton University Medical Center, Omaha, Neb 68131, USA.
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MeSH Terms
Aneurysm, Dissecting / mortality,  surgery*
Aorta, Thoracic / surgery*
Aortic Aneurysm, Thoracic / mortality,  surgery*
Aortic Rupture / surgery*
Blood Vessel Prosthesis Implantation
Follow-Up Studies
Middle Aged
Monitoring, Intraoperative
Retrospective Studies
Surgery, Computer-Assisted*
Survival Rate
Treatment Outcome
Vascular Patency
Vascular Surgical Procedures / adverse effects,  methods*,  mortality

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

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