Chinese Journal of Thoracic and Cardiovascular Surgery 2010;26(6):385-388

doi:10.3760/cma.j.issn.1001-4497.2010.06.008

Thoracic endovascular aortic repair of chronic type B aortic dissection in 84 patients

Sheng YANG ; Fangjiong HUANG ; Zhanming FAN ; Zhizhong LI ; Jiahui DU ; Zhaoguang ZHANG ; Shangdong XU

Keywords

Aneurysm,dissecting; Cardiac surgical procedures; Thoracic endovascular aortic repair

Country

China

Language

Chinese

Abstract

Objective The optimal treatment for chronic type B dissection remains controversial. The purpose of this study was to report early and mid-term results of thoracic endovascular aortic repair (TEVAR) of chronic type B aortic dissection. Methods Methods From June 2001 to September 2007, 84 patients with chronic type B aortic dissection received TEVAR. The time between onset of dissection and TEVAR was (13.9 ± 22.0) months (ranged 1 - 120 months). All patients were followed for 6 - 86 months [mean (33.2 ± 19.2) months]. Results The entry tear was completely sealed in 77 cases ( 91.7% ) during TEVAR. The incidence of incomplete seal was 8.3%. One-month mortality was 1. 2%. One patient had retrograde type A dissection 1 month after operation. Four patients received a second TEVAR during follow-up :3 for endoleaking and 1 for newly formed intima tear. Seven patients (8.3%) died during follow-up: 3 thoracic aorta rupture due to endoleaking, 1 abdominal aorta rupture caused by continuous dilation of the abdominal aorta, unrelated to aortic dissection deaths in 2 and 1 died of unknown cause. The Kaplan Meier actuarial survival curve showed a 7-year survival rate of 84.4%. Conclusion Early and mid-term results showed that TEVAR was effective in treating chronic type B aortic dissection. Endoleak was the main cause of death during follow-up. With increasing of physician's experience and refinement of the stent-graft, results are likely to improve in the future.