These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Clinical outcomes and fate of the distal aorta following 1-stage repair of extensive chronic thoracic aortic dissection.
    Author: Kouchoukos NT, Kulik A, Castner CF.
    Journal: J Thorac Cardiovasc Surg; 2013 Nov; 146(5):1086-91. PubMed ID: 23998783.
    Abstract:
    OBJECTIVE: To 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. METHODS: Among 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. RESULTS: The 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. CONCLUSIONS: Our 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.
    [Abstract] [Full Text] [Related] [New Search]