Descending thoracic aortic repair outcomes for chronic aortic dissection: a single-centre experience. (14th September 2022)

• Record Type: Journal Article
• Authors: Yamane, Yoshitaka; Oshima, Susumu; Ishiko, Kazumasa; Okiyama, Makoto; Hirokami, Tomohiro; Hirai, Yuki; Sakurai, Shigeru; Ozaki, Kensuke; Yoshimura, Kenichi; Takahashi, Shinya; Yamamoto, Shin
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 35:Number 4(2022)
• Publication Date: 2022-09-14
• Subjects: Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivac233
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: OBJECTIVES: Thoracic endovascular aortic repair is a widely accepted treatment for chronic aortic dissection because of good early results compared to open surgical repair. We provide early and long-term results of descending thoracic aortic repair for chronic aortic dissection. METHODS: Patients who underwent descending thoracic aortic repair for chronic aortic dissection between January 2012 and December 2020 at Kawasaki Aortic Centre were included in this analysis. RESULTS: Four hundred ninety-two patients (median age, 64 years; interquartile range, 52–75 years) were included. The median duration of follow-up was 3.2 years (interquartile range, 1.5–5.2 years). The early mortality rate was 2.0% (n = 10); strokes occurred in 17 patients (3.5%); and spinal cord injuries occurred in 30 patients (6.1%). Early major adverse events including early death, stroke, spinal cord injury, tracheostomy and haemodialysis at the time of discharge occurred in 62 patients. Multivariable analysis indicated that age > 70 years and non-elective surgery were predictors of early major adverse events. Among patients without both risk factors (i.e. low-risk patients), 1 early death (0.4%), 3 strokes (1.5%) and 1 spinal cord injury (0.4%) were observed, 2 tracheostomies were performed (0.8%) and no patients required haemodialysis at the time of hospital discharge. The 5-year survival rate was 87.2%. The cumulative incidence of chronic aortic dissection-related aortic reintervention at 5 years was 7.9%. CONCLUSIONS: Descending thoracic aortic repair for chronic aortic dissection resulted in good early and long-term results, and it can serve as the gold standard for low-risk patients. Abstract : Open surgical repair (OSR) has long been the gold standard for chronic aortic dissection (CAD).