Woong Chol Kang1, Young-Guk Ko2, Eak Kyun Shin1, Chul-Hyun Park3, Donghoon Choi4, Young Nam Youn5, Do Yun Lee6. 1. Cardiology, Gil Medical Center, Gachon University, Incheon, Republic of Korea. 2. Cardiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea. Electronic address: ygko@yuhs.ac. 3. Cardiothoracic Surgery, Gil Medical Center, Gachon University, Incheon, Republic of Korea. 4. Cardiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea. 5. Cardiothoracic Surgery, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea. 6. Radiology, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea.
Abstract
BACKGROUND: To compare the outcomes of hybrid endovascular and open surgical repair for proximal aortic arch diseases. METHODS: A total of 55 consecutive patients with aortic arch aneurysm or aortic dissection involving any of zone 0 to 1 (39 male, age 63.4 ± 14.3 years) underwent a hybrid endovascular repair (n=35) or open surgical repair (n=20) from 2006 to 2014 were analyzed retrospectively. Perioperative and late outcomes were compared. RESULTS: Baseline characteristics were similar between the two groups, except age and EuroSCORE II, which were higher in the hybrid group. Perioperative mortality or stroke was not significantly different between the two groups, however, tended to be lower in the hybrid repair group than in the open repair group (11.4% vs. 30.0%, p=0.144). Incidences of other morbidities did not differ. During follow-up, over-all survival was similar between the hybrid and the open repair was similar (87.3% vs. 79.7% at 1 year and 83.8% vs. 72.4% at 3 years; p=0.319). However, reintervention-free survival was significantly lower for hybrid repair compared with open repair (83.8% vs. 100% at 1 year and 65.7% vs. 100% at 3 years; p=0.022). CONCLUSIONS: Hybrid repair of proximal aortic disease showed comparable perioperative and late outcomes compared with open surgical repair despite a higher reintervention rate during follow-up. Therefore, hybrid repair may be considered as an acceptable treatment alternative to surgery especially in patients at high surgical risk.
BACKGROUND: To compare the outcomes of hybrid endovascular and open surgical repair for proximal aortic arch diseases. METHODS: A total of 55 consecutive patients with aortic arch aneurysm or aortic dissection involving any of zone 0 to 1 (39 male, age 63.4 ± 14.3 years) underwent a hybrid endovascular repair (n=35) or open surgical repair (n=20) from 2006 to 2014 were analyzed retrospectively. Perioperative and late outcomes were compared. RESULTS: Baseline characteristics were similar between the two groups, except age and EuroSCORE II, which were higher in the hybrid group. Perioperative mortality or stroke was not significantly different between the two groups, however, tended to be lower in the hybrid repair group than in the open repair group (11.4% vs. 30.0%, p=0.144). Incidences of other morbidities did not differ. During follow-up, over-all survival was similar between the hybrid and the open repair was similar (87.3% vs. 79.7% at 1 year and 83.8% vs. 72.4% at 3 years; p=0.319). However, reintervention-free survival was significantly lower for hybrid repair compared with open repair (83.8% vs. 100% at 1 year and 65.7% vs. 100% at 3 years; p=0.022). CONCLUSIONS: Hybrid repair of proximal aortic disease showed comparable perioperative and late outcomes compared with open surgical repair despite a higher reintervention rate during follow-up. Therefore, hybrid repair may be considered as an acceptable treatment alternative to surgery especially in patients at high surgical risk.
Authors: Orhan Gökalp; Levent Yılık; Hasan İner; Yüksel Beşir; Nihan Karakaş Yeşilkaya; Kazım Ergüneş; Banu Lafcı; Ali Gürbüz Journal: Turk Gogus Kalp Damar Cerrahisi Derg Date: 2018-07-03 Impact factor: 0.332