Outcomes of Open Surgical Repair of Descending Thoracic Aortic Disease.
- Author:
Won Young LEE
1
;
Jae Suk YOO
;
Joon Bum KIM
;
Sung Ho JUNG
;
Suk Jung CHOO
;
Cheol Hyun CHUNG
;
Jae Won LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. jbkim1975@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Aorta;
Descending thoracic aorta;
Cardiopulmonary bypass
- MeSH:
Aorta;
Aortic Diseases*;
Cardiac Output, Low;
Cardiopulmonary Bypass;
Circulatory Arrest, Deep Hypothermia Induced;
Female;
Follow-Up Studies;
Heart Ventricles;
Humans;
Mortality;
Paraplegia;
Pneumonia;
Renal Dialysis;
Reoperation;
Risk Factors;
Stroke
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2014;47(3):255-261
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair. METHODS: We identified 103 patients (23 females; mean age, 64.1+/-12.3 years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%). RESULTS: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was 80.9%+/-4.3% and 71.7%+/-5.9%, respectively. Reoperation-free survival at 5 and 10 years was 77.3%+/-4.8% and 70.2%+/-5.8%. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p<0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p<0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49). CONCLUSION: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.
