Outcomes of Open Surgical Repair of Descending Thoracic Aortic Disease
The Korean Journal of Thoracic and Cardiovascular Surgery
; : 255-261, 2014.
Article
in En
| WPRIM
| ID: wpr-215831
Responsible library:
WPRO
ABSTRACT
BACKGROUND: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair. METHODS: We identified 103 patients (23 females; mean age, 64.1+/-12.3 years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%). RESULTS: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was 80.9%+/-4.3% and 71.7%+/-5.9%, respectively. Reoperation-free survival at 5 and 10 years was 77.3%+/-4.8% and 70.2%+/-5.8%. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p<0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p<0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49). CONCLUSION: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.
Key words
Full text:
1
Database:
WPRIM
Main subject:
Aorta
/
Aortic Diseases
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Paraplegia
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Pneumonia
/
Reoperation
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Cardiac Output, Low
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Cardiopulmonary Bypass
/
Risk Factors
/
Follow-Up Studies
/
Mortality
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
Language:
En
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2014
Document type:
Article