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Thoracic Endovascular Aortic Repair for Ruptured Descending Thoracic Aortic Aneurysm
Author(s) -
Minami Tomoyuki,
Imoto Kiyotaka,
Uchida Keiji,
Karube Norihisa,
Yasuda Shota,
Choh Tomoki,
Suzuki Shinichi,
Masuda Munetaka
Publication year - 2015
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12499
Subject(s) - medicine , surgery , paraplegia , perforation , aortic dissection , aortic repair , thoracic aortic aneurysm , aortic aneurysm , aneurysm , aortic rupture , mortality rate , aorta , spinal cord , punching , materials science , psychiatry , metallurgy
A BSTRACT Background We evaluated clinical outcomes of thoracic endovascular aortic repair (TEVAR) for ruptured descending thoracic aortic aneurysm (rDTAA). Methods Twenty‐three patients with rDTAA (mean age, 76.8 ± 8.8 years) underwent TEVAR at our center between January 2008 and April 2013. Results In twenty‐three patients, five patients (21.7%) were in shock before surgery. Technical success was achieved in 21 patients. After TEVAR, retrograde Type A aortic dissection occurred in one patient, Type I endoleak in one patient, and Type II endoleak in three patients. The 30‐day mortality rate was 4.3% (n = 1), and there were five in‐hospital deaths (21.7%). Six patients (26.1%) developed cerebral complications and two patients suffered from paraplegia. In the late phase, four patients died because of the following aortic events: re‐rupture in one patient, rupture of another untreated aneurysm in two patients, and esophageal perforation in one patient. Conclusions TEVAR is associated with relatively low early morbidity and mortality and can be performed in older and high‐risk patients. However, because aortic events during follow‐up after TEVAR are not rare, we recommend close follow‐up and application of early and aggressive reintervention. doi: 10.1111/jocs.12499 (J Card Surg 2015;30:163–169)