Is Hybrid Repair for an Entire Shaggy Aorta Feasible?
Heart Lung Circ
; 30(5): 765-772, 2021 May.
Article
em En
| MEDLINE
| ID: mdl-33139174
ABSTRACT
OBJECTIVE:
This paper reviewed clinical experiences to evaluate the feasibility of a surgical strategy for an entire shaggy aorta.METHODS:
Fifty-two (52) surgeries (47 men, average age 72±7 years) were performed for an entire shaggy aorta at the current institution from 2002-2017. Open surgery was performed in 30 cases, including total arch replacement in 12, extended aortic arch replacement via L-shaped thoracotomy in 10 and median sternotomy combined with left thoracotomy in two, and thoracoabdominal aortic replacement in six. Hybrid procedures were performed in 22 cases type I hybrid arch repair in six, type II hybrid arch repair in seven and type III hybrid arch repair in nine.RESULTS:
Hospital mortality was significantly higher with a hybrid repair surgical, one case (3%); hybrid, six cases (27%), (p=0.0125). Stroke occurred at relatively high rates in both groups surgical, seven cases (23%); hybrid, six cases (27%) (p=0.75). Spinal cord injury was significantly higher in hybrid repair surgical, one case (3%); hybrid, seven cases (32%), (p=0.004). Open surgery revealed a better long-term survival rate than the hybrid procedure at 5 and 10 years surgical, 82%, 65.7%; hybrid, 53%, 35.1%, respectively (p=0.0452). The rate of freedom from aortic events was significantly better with open surgery than a hybrid procedure at 5 and 10 years surgical, 96%, 85%; hybrid, 83%, 41.3%, respectively (p=0.0082).CONCLUSIONS:
Surgery for an entire shaggy aorta was frequently associated with embolic complications such as stroke, paraplegia, renal failure, and bowel necrosis. However, open surgical repair may produce better early and late outcomes and freedom from aortic events compared with hybrid repair.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aneurisma da Aorta Torácica
/
Implante de Prótese Vascular
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article