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J Chest Surg

Published online April 7, 2021

Copyright © Journal of Chest Surgery.

Mid-Term Results of Thoracic Endovascular Aortic Repair for Complicated Acute Type B Aortic Dissection at a Single Center

Young Kwang Hong, M.D.1 , Won Ho Chang, M.D., Ph.D.1 , Dong Erk Goo, M.D., Ph.D.2 , Hong Chul Oh, M.D.1 , Young Woo Park, M.D., Ph.D.1

Departments of 1Thoracic and Cardiovascular Surgery and 2Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea

Correspondence to:Won Ho Chang
Tel 82-2-710-3084
Fax 82-2-709-9083
E-mail changwh@schmc.ac.kr
ORCID
https://orcid.org/0000-0002-0234-4478

Received: December 14, 2020; Revised: February 3, 2021; Accepted: February 16, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Complicated acute type B aortic dissection is a life-threatening condition with high morbidity and mortality. The aim of this study was to report a single-center experience with endovascular stent-graft repair of acute type B dissection of the thoracic aorta and to evaluate the mid-term outcomes.
Methods: We reviewed 18 patients treated for complicated acute type B aortic dissection by thoracic endovascular aortic repair (TEVAR) from September 2011 to July 2017. The indications for surgery included rupture, impending rupture, limb ischemia, visceral malperfusion, and paraplegia. The median follow-up was 34.50 months (range, 12–80 months).
Results: The median interval from aortic dissection to TEVAR was 5.50 days (range, 0–32 days). There was no in-hospital mortality. All cases of malperfusion improved except for 1 patient. The morbidities included endoleak in 2 patients (11.1%), stroke in 3 patients (16.7%), pneumonia in 2 patients (11.1%), transient ischemia of the left arm in 1 patient (5.6%), and temporary visceral ischemia in 1 patient (5.6%). Postoperative computed tomography angiography at 1 year showed complete thrombosis of the false lumen in 15 patients (83.3%).
Conclusion: TEVAR of complicated type B aortic dissection with a stent-graft was effective, with a low morbidity and mortality rate.

Keywords: Aortic dissection, Ischemia, Outcomes

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J Chest Surg

Published online April 7, 2021

Copyright © Journal of Chest Surgery.

Mid-Term Results of Thoracic Endovascular Aortic Repair for Complicated Acute Type B Aortic Dissection at a Single Center

Young Kwang Hong, M.D.1 , Won Ho Chang, M.D., Ph.D.1 , Dong Erk Goo, M.D., Ph.D.2 , Hong Chul Oh, M.D.1 , Young Woo Park, M.D., Ph.D.1

Departments of 1Thoracic and Cardiovascular Surgery and 2Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea

Correspondence to:Won Ho Chang
Tel 82-2-710-3084
Fax 82-2-709-9083
E-mail changwh@schmc.ac.kr
ORCID
https://orcid.org/0000-0002-0234-4478

Received: December 14, 2020; Revised: February 3, 2021; Accepted: February 16, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Complicated acute type B aortic dissection is a life-threatening condition with high morbidity and mortality. The aim of this study was to report a single-center experience with endovascular stent-graft repair of acute type B dissection of the thoracic aorta and to evaluate the mid-term outcomes.
Methods: We reviewed 18 patients treated for complicated acute type B aortic dissection by thoracic endovascular aortic repair (TEVAR) from September 2011 to July 2017. The indications for surgery included rupture, impending rupture, limb ischemia, visceral malperfusion, and paraplegia. The median follow-up was 34.50 months (range, 12–80 months).
Results: The median interval from aortic dissection to TEVAR was 5.50 days (range, 0–32 days). There was no in-hospital mortality. All cases of malperfusion improved except for 1 patient. The morbidities included endoleak in 2 patients (11.1%), stroke in 3 patients (16.7%), pneumonia in 2 patients (11.1%), transient ischemia of the left arm in 1 patient (5.6%), and temporary visceral ischemia in 1 patient (5.6%). Postoperative computed tomography angiography at 1 year showed complete thrombosis of the false lumen in 15 patients (83.3%).
Conclusion: TEVAR of complicated type B aortic dissection with a stent-graft was effective, with a low morbidity and mortality rate.

Keywords: Aortic dissection, Ischemia, Outcomes

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