ABSTRACT
PURPOSE: We describe a retrospective study of initial and long-term outcomes with an open stent grafting (OSG) with a Matsui-Kitamura stent for treating thoracic aortic aneurysm. METHODS: Between August 2005 and September 2013, 50 patients with aortic arch disease extending to the descending aorta underwent OSG. Circulatory arrest with total cardiopulmonary bypass and selective cerebral perfusion were used, and the aorta was transected between the brachiocephalic and left subclavian artery. The stent-graft was inserted, sutured to a transected aortic edge, and anastomosed to a four-branched arch graft. Preoperative, operative, and short- and long-term postoperative data were obtained from the patients' medical records. RESULTS: The perioperative (within 30 days) mortality rate was 8%. Two patients (4%) had a stroke and 5 patients (10%) had a spinal cord injury resulting in paraplegia or paraparesis (1 patient each) or transient paraplegia (3 patients). Actuarial survival rates at 1, 3, 5, and 7 years postoperatively were 87.8%, 78.3%, 70.7%, and 65.3%, respectively; the rates of freedom from an aortic event were 100%, 89.1%, 82.2%, and 74.7%. There were no complications related to use of the stent-graft. CONCLUSION: Our OSG method provided durable results in patients treated for thoracic aortic aneurysm, with few adverse events.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis , Endovascular Procedures/instrumentation , Stents , Aged , Aged, 80 and over , Anastomosis, Surgical , Aortic Aneurysm, Thoracic/diagnosis , Aortic Aneurysm, Thoracic/mortality , Aortography/methods , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/mortality , Disease-Free Survival , Endovascular Procedures/adverse effects , Endovascular Procedures/mortality , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Postoperative Complications/etiology , Prosthesis Design , Retrospective Studies , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Emergency conventional surgical repair of the descending thoracic aorta remains a therapeutic challenge and is associated with a high risk of mortality. We describe a case of ruptured descending thoracic aortic aneurysm in an 87-year-old man who presented with chest and back pain. The patient underwent successful endovascular repair of the lesion with the use of Gore TAG thoracic endoprosthesis. Post-procedure computed tomography showed complete exclusion of the aneurysm without endoleaks. Endovascular repair is feasible and can be effective in such cases.
