Abstract
Purpose: We investigated the surgical results of secondary thoracic endovascular aneurysm repair (TEVAR) using the elephant trunk graft after total aortic arch replacement (TAR) for extensive thoracic aortic lesions. Methods: The subjects comprised 16 patients who underwent TEVAR as a staged procedure following TAR at our institution between 1997 and 2007. Long-term results were retrospectively surveyed (mean observation period 68.4 months). We performed TEVAR with the elephant trunk graft as a proximal landing zone for the descending thoracic repair, the mean duration between TAR and TEVAR was 4.7 weeks for the staged operations and 18.3 months for the nonstaged operations. Results: Early results were good in all cases, with no deaths and no noteworthy complications. For the seven patients without dissection, long-term results were also good. Among the nine patients with dissection, the false lumen in the thoracoabdominal area enlarged in three during follow-up. We performed thoracoabdominal repair in two, but one died of an aneurysm-esophageal fistula. There was only one long-term aneurysm-related death. Conclusion: Second-stage TEVAR using the elephant trunk graft after TAR allows less invasive surgery for extensive aortic lesions and achieves good long-term results. However, enlargement of the false lumen was a long-term concern in patients with aortic dissection, and careful follow-up is essential.
| Original language | English |
|---|---|
| Pages (from-to) | 501-505 |
| Number of pages | 5 |
| Journal | General Thoracic and Cardiovascular Surgery |
| Volume | 58 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2010 Oct |
| Externally published | Yes |
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Keywords
- Cardiovascular surgical procedure
- Dissecting aneurysms
- Thoracic aneurysms
- Thoracic endovascular aortic repair
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
Cite this
Long-term results of second-stage thoracic endovascular aortic repair following total aortic arch replacement. / Obitsu, Yukio; Koizumi, Nobusato; Iida, Yasunori; Iwahashi, Toru; Saiki, Naozumi; Watanabe, Yoshiko; Takae, Hisahito; Kawaguchi, Satoshi; Shigematsu, Hiroshi.
In: General Thoracic and Cardiovascular Surgery, Vol. 58, No. 10, 10.2010, p. 501-505.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term results of second-stage thoracic endovascular aortic repair following total aortic arch replacement
AU - Obitsu, Yukio
AU - Koizumi, Nobusato
AU - Iida, Yasunori
AU - Iwahashi, Toru
AU - Saiki, Naozumi
AU - Watanabe, Yoshiko
AU - Takae, Hisahito
AU - Kawaguchi, Satoshi
AU - Shigematsu, Hiroshi
PY - 2010/10
Y1 - 2010/10
N2 - Purpose: We investigated the surgical results of secondary thoracic endovascular aneurysm repair (TEVAR) using the elephant trunk graft after total aortic arch replacement (TAR) for extensive thoracic aortic lesions. Methods: The subjects comprised 16 patients who underwent TEVAR as a staged procedure following TAR at our institution between 1997 and 2007. Long-term results were retrospectively surveyed (mean observation period 68.4 months). We performed TEVAR with the elephant trunk graft as a proximal landing zone for the descending thoracic repair, the mean duration between TAR and TEVAR was 4.7 weeks for the staged operations and 18.3 months for the nonstaged operations. Results: Early results were good in all cases, with no deaths and no noteworthy complications. For the seven patients without dissection, long-term results were also good. Among the nine patients with dissection, the false lumen in the thoracoabdominal area enlarged in three during follow-up. We performed thoracoabdominal repair in two, but one died of an aneurysm-esophageal fistula. There was only one long-term aneurysm-related death. Conclusion: Second-stage TEVAR using the elephant trunk graft after TAR allows less invasive surgery for extensive aortic lesions and achieves good long-term results. However, enlargement of the false lumen was a long-term concern in patients with aortic dissection, and careful follow-up is essential.
AB - Purpose: We investigated the surgical results of secondary thoracic endovascular aneurysm repair (TEVAR) using the elephant trunk graft after total aortic arch replacement (TAR) for extensive thoracic aortic lesions. Methods: The subjects comprised 16 patients who underwent TEVAR as a staged procedure following TAR at our institution between 1997 and 2007. Long-term results were retrospectively surveyed (mean observation period 68.4 months). We performed TEVAR with the elephant trunk graft as a proximal landing zone for the descending thoracic repair, the mean duration between TAR and TEVAR was 4.7 weeks for the staged operations and 18.3 months for the nonstaged operations. Results: Early results were good in all cases, with no deaths and no noteworthy complications. For the seven patients without dissection, long-term results were also good. Among the nine patients with dissection, the false lumen in the thoracoabdominal area enlarged in three during follow-up. We performed thoracoabdominal repair in two, but one died of an aneurysm-esophageal fistula. There was only one long-term aneurysm-related death. Conclusion: Second-stage TEVAR using the elephant trunk graft after TAR allows less invasive surgery for extensive aortic lesions and achieves good long-term results. However, enlargement of the false lumen was a long-term concern in patients with aortic dissection, and careful follow-up is essential.
KW - Cardiovascular surgical procedure
KW - Dissecting aneurysms
KW - Thoracic aneurysms
KW - Thoracic endovascular aortic repair
UR - http://www.scopus.com/inward/record.url?scp=77958082023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77958082023&partnerID=8YFLogxK
U2 - 10.1007/s11748-010-0627-6
DO - 10.1007/s11748-010-0627-6
M3 - Article
C2 - 20941562
AN - SCOPUS:77958082023
VL - 58
SP - 501
EP - 505
JO - General Thoracic and Cardiovascular Surgery
JF - General Thoracic and Cardiovascular Surgery
SN - 1863-6705
IS - 10
ER -