E Rosset1, S Ben Ahmed2, G Galvaing2, J P Favre3, C Sessa4, P Lermusiaux5, R Hassen-Khodja6, M Coggia7, S Haulon8, S Rinckenbach9, B Enon10, P Feugier4, E Steinmetz11, J P Becquemin12. 1. CHU Clermont-Ferrand, France. Electronic address: erosset@chu-clermontferrand.fr. 2. CHU Clermont-Ferrand, France. 3. CHU Saint-Etienne, France. 4. CHU Grenoble, France. 5. CHU Lyon, France. 6. CHU Nice, France. 7. Ambroise Paré Hospital, France. 8. CHU Lille, France. 9. CHU Besançon, France. 10. CHU Angers, France. 11. CHU Dijon, France. 12. CHU Henri Mondor, Creteil, France.
Abstract
OBJECTIVES: The aim of this study was to assess the results of hybrid techniques for the treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms based on multicenter results and the various series regarding hybrid procedures reported in the literature. METHODS: The results of 76 hybrid procedures performed in 19 French university hospital centers between November 2001 and October 2011 were collected. There were 50 men and 26 women, mean age 68.2 (35-86) years. All patients were considered at high risk (ASA≥3) for conventional surgery. Aneurysms involved the thoracic, abdominal, and thoracoabdominal aorta in five, 14, and 57 cases respectively. There were 11 emergent repairs. The revascularization of four visceral arteries was performed in 38 cases. Between one and three visceral arteries were revascularized in the other cases. Visceral artery debranching and stent graft deployment were performed in a one-stage procedure in 53 cases and in a two-stage procedure in 23 cases. RESULTS: There were 26 (34.2%) postoperative deaths. Nine of the survivors developed paraplegia, of which one resolved completely. Bowel ischemia occurred in 13 cases (17.1%), and one patient was treated by a superior mesenteric artery bypass. Four patients required long-term hemodialysis. Postoperative computed tomography scan showed a type II endoleak in two patients. CONCLUSIONS: Morbidity and mortality in this study were greater than previously reported. Candidates for hybrid aortic repair should be carefully selected.
OBJECTIVES: The aim of this study was to assess the results of hybrid techniques for the treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms based on multicenter results and the various series regarding hybrid procedures reported in the literature. METHODS: The results of 76 hybrid procedures performed in 19 French university hospital centers between November 2001 and October 2011 were collected. There were 50 men and 26 women, mean age 68.2 (35-86) years. All patients were considered at high risk (ASA≥3) for conventional surgery. Aneurysms involved the thoracic, abdominal, and thoracoabdominal aorta in five, 14, and 57 cases respectively. There were 11 emergent repairs. The revascularization of four visceral arteries was performed in 38 cases. Between one and three visceral arteries were revascularized in the other cases. Visceral artery debranching and stent graft deployment were performed in a one-stage procedure in 53 cases and in a two-stage procedure in 23 cases. RESULTS: There were 26 (34.2%) postoperative deaths. Nine of the survivors developed paraplegia, of which one resolved completely. Bowel ischemia occurred in 13 cases (17.1%), and one patient was treated by a superior mesenteric artery bypass. Four patients required long-term hemodialysis. Postoperative computed tomography scan showed a type II endoleak in two patients. CONCLUSIONS: Morbidity and mortality in this study were greater than previously reported. Candidates for hybrid aortic repair should be carefully selected.
Authors: Ayman A Saeyeldin; Camilo A Velasquez; Syed Usman B Mahmood; Adam J Brownstein; Mohammad A Zafar; Bulat A Ziganshin; John A Elefteriades Journal: Gen Thorac Cardiovasc Surg Date: 2017-12-04
Authors: Ehsan Benrashid; Hanghang Wang; Nicholas D Andersen; Jeffrey E Keenan; Richard L McCann; G Chad Hughes Journal: J Vasc Surg Date: 2016-07-18 Impact factor: 4.268