Descending thoracic aortic repair outcomes for chronic aortic dissection: a single-centre experience

Author:

Yamane Yoshitaka1,Oshima Susumu1,Ishiko Kazumasa1,Okiyama Makoto1,Hirokami Tomohiro1,Hirai Yuki1,Sakurai Shigeru1,Ozaki Kensuke1,Yoshimura Kenichi2,Takahashi Shinya3,Yamamoto Shin1

Affiliation:

1. Kawasaki Aortic Center, Kawasaki Saiwai Hospital , Kawasaki, Japan

2. Department of Biostatistics, Medical Center for Translational and Clinical Research, Hiroshima University Hospital , Hiroshima, Japan

3. Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University , Hiroshima, Japan

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.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,Surgery

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