Ikeno Yuki, Miyahara Shunsuke, Koda Yojiro, Yokawa Koki, Gotake Yasuko, Henmi Soichiro, Nakai Hidekazu, Matsueda Takashi, Inoue Takeshi, Tanaka Hiroshi, Okita Yutaka
Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Interact Cardiovasc Thorac Surg. 2018 Oct 1;27(4):574-580. doi: 10.1093/icvts/ivy139.
This study evaluated the early and long-term outcomes of open surgery after thoracic endovascular aortic repair.
We conducted a retrospective review of 41 patients who underwent open surgery following thoracic endovascular aortic repair between October 1999 and July 2017. The mean interval from primary intervention to open surgery was 3.1 ± 3.7 years. Indications for open repair were endoleak in 14 patients, graft infection in 10 patients, false lumen dilatation in 9 patients, retrograde dissection in 5 patients, migration in 1 patient and additional aneurysm in 2 patients. Eight patients underwent emergent surgical conversions. The mean follow-up period was 4.2 ± 4.0 years.
Descending aortic replacement was performed in 15 patients; thoraco-abdominal aortic repair, in 14 patients; extensive arch to descending aortic replacement, in 5 patients; and total arch replacement, in 7 patients. Six (14.6%) patients died in the hospital. The 5-year survival rate was 73.7 ± 7.2%, and freedom from reintervention was 88.5 ± 6.4%.
Early outcomes of open surgical procedures after thoracic endovascular aortic repair were still suboptimal. However, hospital survivors had excellent long-term outcomes.
