Midterm Outcomes of Open Surgical Repair Compared with Thoracic Endovascular Repair for Isolated Descending Thoracic Aortic Disease |
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Authors: | Seung Hyun Lee Cheol Hyun Chung Sung Ho Jung Jae Won Lee Ji Hoon Shin Ki young Ko Hyun Ki Yoon Suk Jung Choo |
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Institution: | 1Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University College of Medicine, Daegu 700-712, Korea.;2Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.;3Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea. |
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Abstract: | ObjectiveThis study aimed to assess the surgical morbidity and mortality of thoracic endovascular repair (TEVAR) as compared with open surgical repair (OSR) for isolated descending thoracic aortic disease.Materials and MethodsFrom January 1, 2006 through May 31, 2010, a total of 68 patients with isolated descending thoracic aortic disease were retrospectively reviewed for the presence of perioperative complication, 30-day mortality, and clinical success. The patients were divided into two groups (group 1, OSR, n = 40 vs. group 2, TEVAR, n = 28) and these groups were compared for major variables and late outcomes.ResultsThe mean age was 58 years (group I = 54 vs. group II = 63 years, p = 0.011). Significant perioperative complications occurred in 12 patients: 8 (20%) in group I and 4 (13%) in group II (p = 0.3). There were five 30 day mortalities of which 4 occurred in group I and 1 in group II (p = 0.23). Clinical success (effective aortic remodeling and complete false lumen obliteration or thrombosis) was achieved in 20 patients (71%). Mean Kaplan-Meier survival rate at 1 year was similar for both groups (group 1 = 87% vs. group 2 = 80%, p = 0.65).ConclusionThoracic endovascular repair for isolated thoracic aortic disease shows comparable results to OSR. However, the potential for endoleak or rupture remains a challenge that needs to be addressed in the future. Therefore, close follow-up study is needed for the evaluation of satisfactory long-term outcomes. |
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Keywords: | Descending aorta disease Thoracic endovascular repair Open surgical repair |
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