Qingsheng Lu1, Lei Liu2, Guangqi Chang3, Xueming Chen4, Hai Feng4, Xuemin Zhang5, Weiguo Fu6, Zhihui Dong6, Zaiping Jing7. 1. Vascular surgery department, Changhai hospital, the Second military medical university, Shanghai, China. Electronic address: luqs@xueguan.net. 2. Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, the Second military medical university, Shanghai, China. 3. Vascular surgery department, the first affiliated hospital of Sun Yat-sen University, Guangzhou, China. 4. Vascular surgery department, Beijing Friendship Hospital, the affiliated hospital of Capital Medical University, Beijing, China. 5. Vascular Surgery Department, Peking University People's Hospital, Beijing, China. 6. Vascular surgery department, Zhongshan Hospital, the affiliated hospital of Fudan University, Shanghai, China. 7. Vascular surgery department, Changhai hospital, the Second military medical university, Shanghai, China. Electronic address: jingzp@xueguan.net.
Abstract
OBJECTIVES: This study aims to report mid-term follow-up outcomes of a series of TAAD patients treated with TEVAR in China. BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has been used to treat type A aortic dissection (TAAD) for years. However, by comparing public reports, their outcomes which were based on different sample sizes show inconsistency. METHODS: Between January 2001 and December 2015, there were 56 patients with TAAD received TEVAR identified in 5 medical centers. The morphology changes and early and late outcomes were recorded and analyzed. RESULTS: 56 patients (aged 38 to 80) with TAAD received TEVAR. The average follow-up period was 39.92 ± 34.42 months (ranging from 11 to 140 months). 54 (96.43%) cases were technically successful. 1 patient died on day 2 after TEVAR because of stent graft migration during the procedure. There were 7 early events (within 30 days), including sudden death (1), cerebral infarction (3), stent graft migration (1), new dissection (1) and respiratory failure (1). The 30-day overall survival rate was 92.9%. 27 late events occurred during the follow-up: retrograde dissection (8), endoleak (5), coronary artery stenosis (3), cerebral infarction (3), new dissection (2), multiple organ dysfunction syndrome (1), left ventricular pseudoaneurysm (1), stent graft migration (1), respiratory failure (1), supraventricular tachycardia (1) and pericardial effusion (1). The 5-year overall survival rate of this study was 80.9% and this rate reached 98.2% if aorta-related deaths were excluded. CONCLUSIONS: TEVAR could be an effective alternative for high-risk patients. However, issues resulted from postoperative complications still call for attention.
OBJECTIVES: This study aims to report mid-term follow-up outcomes of a series of TAAD patients treated with TEVAR in China. BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has been used to treat type A aortic dissection (TAAD) for years. However, by comparing public reports, their outcomes which were based on different sample sizes show inconsistency. METHODS: Between January 2001 and December 2015, there were 56 patients with TAAD received TEVAR identified in 5 medical centers. The morphology changes and early and late outcomes were recorded and analyzed. RESULTS: 56 patients (aged 38 to 80) with TAAD received TEVAR. The average follow-up period was 39.92 ± 34.42 months (ranging from 11 to 140 months). 54 (96.43%) cases were technically successful. 1 patient died on day 2 after TEVAR because of stent graft migration during the procedure. There were 7 early events (within 30 days), including sudden death (1), cerebral infarction (3), stent graft migration (1), new dissection (1) and respiratory failure (1). The 30-day overall survival rate was 92.9%. 27 late events occurred during the follow-up: retrograde dissection (8), endoleak (5), coronary artery stenosis (3), cerebral infarction (3), new dissection (2), multiple organ dysfunction syndrome (1), left ventricular pseudoaneurysm (1), stent graft migration (1), respiratory failure (1), supraventricular tachycardia (1) and pericardial effusion (1). The 5-year overall survival rate of this study was 80.9% and this rate reached 98.2% if aorta-related deaths were excluded. CONCLUSIONS:TEVAR could be an effective alternative for high-risk patients. However, issues resulted from postoperative complications still call for attention.
Authors: Alexander A Brescia; Himanshu J Patel; Donald S Likosky; Tessa M F Watt; Xiaoting Wu; Raymond J Strobel; Karen M Kim; Shinichi Fukuhara; Bo Yang; G Michael Deeb; Michael P Thompson Journal: Ann Thorac Surg Date: 2019-08-07 Impact factor: 4.330