کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2979830 | 1578617 | 2013 | 6 صفحه PDF | دانلود رایگان |

ObjectiveTo analyze clinical outcomes and distal segmental aortic growth and aortic reoperation rates following 1-stage open repair of extensive chronic aortic dissection that included resection and graft replacement of the aneurysmal descending thoracic aorta.MethodsAmong 68 patients undergoing extensive 1-stage repair of chronic aortic dissection that included the ascending aorta, arch, and varying lengths of the descending thoracic aorta, 66 were hospital survivors (early mortality 2.9%). Fifty-one of these patients (77%) had serial imaging studies suitable for calculation of growth rates of the remaining thoracic and upper abdominal aorta. The mean duration of follow-up was 5.8 years and extended to 13.7 years.ResultsThe overall growth rate of the distal aorta for the entire cohort was 0.10 mm/year. For 28 patients followed for >5 years, the growth rate was 0.03 mm/year. Three patients required reoperation on the contiguous thoracic or abdominal aorta for aneurysmal degeneration 8 months, 34 months, and 6.2 years postoperatively. Actuarial freedom from reoperation for aneurysmal growth of the distal aorta at 5 and 10 years was 96.3% and 93.3%, respectively. Actuarial freedom from any aortic reoperation at 5 years and 10 years was 88.6% and 82.7%, respectively. Actuarial survival at 5, 7, and 10 years was 78.2%, 71.2%, and 57.3%, respectively.ConclusionsOur extended experience with the 1-stage procedure confirms its safety and feasibility for treatment of extensive chronic thoracic aortic dissection. It is associated with a low incidence of reoperation on the contiguous aorta for aneurysmal degeneration. It represents a viable alternative to 2-stage and hybrid procedures that are also used to treat this condition.
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 146, Issue 5, November 2013, Pages 1086–1091