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Ann Vasc Surg. 2014 Jan;28(1):201-8. doi: 10.1016/j.avsg.2013.05.002. Epub 2013 Aug 26.

One-stage hybrid repair to thoracoabdominal aortic aneurysm.

Author information

  • 1Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
  • 2Department of Radiology, National Taiwan University Hospital, Taipei, Taiwan.
  • 3Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: ihuiaaronwu@gmail.com.

Abstract

BACKGROUND:

Open repair of a thoracoabdominal aortic aneurysm (TAAA) is associated with high rates of morbidity and mortality. This study reviewed the midterm outcomes of hybrid TAAA repair in high-risk patients at our institution.

METHODS:

The clinical data of patients undergoing 1-stage hybrid repair of a TAAA between June 2007 and June 2011 were retrospectively analyzed. This study represents our experience with 10 patients at a single center who underwent 1-stage visceral hybrid procedures for complex thoracoabdominal aortic pathologies. There were 9 men and 1 woman with a median age of 65.7 years. The average preoperative European System for Cardiac Operative Risk Evaluation II score was 34.1%.

RESULTS:

The technical success rate with completion was 100%. No procedure was abandoned because of any aortic event. The 30-day mortality rate in this study was 10%. Overall major perioperative complication rates were 20%. Major complications included renal impairment requiring permanent support in 1 patient (10%) and paraplegia in 1 patient (10%). At a median follow-up of 20.1 months (range, 0.3-39 months), the overall survival rate was 70%. The primary graft patency rate was 96.8% (32/33). Only 1 renal artery graft was occluded.

CONCLUSIONS:

The midterm results in selected high-risk patients with TAAA undergoing 1-stage hybrid repair were encouraging. When open repair is hazardous and branched stent grafting is not an option, hybrid repair is a viable treatment alternative. However, larger study cohorts and longer durations of follow-up are necessary to provide data on the durability of aortic stent grafts and visceral artery reconstruction.

Copyright © 2014 Elsevier Inc. All rights reserved.

PMID:
23988545
[PubMed - indexed for MEDLINE]
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