Resection of the Descending Thoracic Aorta: Outcomes After Use of Hypothermic Circulatory Arrest

Patel, Himanshu J.; Shillingford, Michael; Mihalik, Scott; Proctor, Mary C.; Deeb, G. Michael

doi:10.1016/j.athoracsur.2006.02.055

Cited by 54 publications

(50 citation statements)

References 19 publications

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“…114,208,209 However, these acceptable results were not corroborated in an American National Inpatient Sample administrative database, presumably reflecting results achieved outside centres of excellence. Mortality rates in elective and emergency cases were 10% and 45%, respectively.…”

Section: Recommenda On 39mentioning

confidence: 90%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

948

259

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Section: Recommenda On 39mentioning

confidence: 90%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

948

259

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“…[1][2][3] On the other hand, extensive surgical aortic replacement using hypothermic circulatory arrest is highly invasive, and its operative mortality remains high. [4][5][6][7] Recently at our institution, we used a novel surgical technique, employing the left axillary artery for perfusion inflow. Perfusion was maintained at 400-600 ml·min -1 at approximately 23˚C during open proximal anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Recent Outcomes of Surgery for Chronic Type B Aortic Dissection

Takagi

Ando

Higuchi

et al. 2010

Annals of Vascular Diseases

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Results: Open proximal anastomosis was performed in 22 patients (56%). In 24 cases (62%), grafts were anastomosed to the true lumen of the peripheral aorta. The early overall mortality rate was 3% (1 patient). Permanent cerebral infarction occurred in 2 patients (5%); and paraparesis, in 1 patient (3%). The KaplanMeier survival estimates were 91% at 2 years and 88% at 5 years. Conclusion: Our surgical strategy is associated with excellent short-term and midterm outcomes. Although further investigation is needed, this strategy may be useful for patients with chronic type B dissection.

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“…Although endovascular stent-graft placement is now an option [8], the standard surgical procedure for chronic type B dissecting aneurysm is currently graft replacement [6,7]. In the pioneering experience of Svensson et al [9], operative morbidity and mortality were high.…”

Section: Discussionmentioning

confidence: 99%

“…In the pioneering experience of Svensson et al [9], operative morbidity and mortality were high. However, operative results have been improving because of innovations such as perioperative cerebrospinal fluid drainage, distal aortic perfusion, reattachment of critical intercostal arteries, permissive hypothermia, and hypothermic circulatory arrest [6,7,10,11]. The in-hospital mortality rate is now 4-10%, and paraplegia or paraparesis occurs in only 2.4-4.5% of patients [6,7,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…However, some lesions subsequently expand and become aneurysmal, especially when the false lumen was patent and the aortic diameter was greater than 40-45 mm preoperatively [4,5]. Graft replacement has been the standard operative technique for chronic dissecting aneurysm [6,7]. Unfortunately, several intercostal arteries are necessarily sacrificed during graft replacement, sometimes resulting in paraplegia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term outcomes after entry closure and aneurysmal wall plication for type B aortic dissection☆

Miyamoto

Ohata

Mitsuno

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Objective: To examine the long-term outcomes after entry closure and aneurysmal wall plication for type B chronic dissecting aortic aneurysm. This procedure uses no artificial graft and preserves all intercostal arteries. Methods: We reviewed the records of 40 consecutive patients who underwent this procedure between September 1983 and December 2002. The mean age at operation was 60 AE 12 years (range, 38-79 years). The mean follow-up period was 9.8 AE 5.1 years (range, 4-23 years). Follow-up was completed in 38 patients (95%). The latest computed tomography scans (n = 22) were obtained 9.5 AE 5.1 years (range, 3-18 years) after surgery. Results: There were no operative deaths and 14 late deaths, none of which were related to the aneurysm. No paraplegia or paraparesis occurred. The survival rate was 92 AE 4% at 5 years and 64 AE 9% at 10 years; 24 patients are still alive. Follow-up computed tomography revealed that the mean diameter of the plicated descending aorta was 31 AE 5 mm (range, 22-39 mm) except in four patients. One of the four patients required reoperation for recurrent aneurysm of the plicated aorta 3 years postoperatively. In the remaining three patients, the plicated aorta has become enlarged; however, these patients have not yet undergone reoperation. Reoperation for residual dissecting aneurysm was performed in another three patients whose plicated aorta was normal. Freedom from reoperation for residual dissecting aneurysm was 78 AE 5% at 10 years. Conclusions: This procedure produces excellent short-term outcomes and low long-term morbidity. It could be the procedure of choice in selected patients to prevent paraplegia, although graft replacement is currently the standard treatment for chronic aortic dissecting aneurysm. #

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Resection of the Descending Thoracic Aorta: Outcomes After Use of Hypothermic Circulatory Arrest

Cited by 54 publications

References 19 publications

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Recent Outcomes of Surgery for Chronic Type B Aortic Dissection

Long-term outcomes after entry closure and aneurysmal wall plication for type B aortic dissection☆

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