초록접수 현황
| 17F-196 | 구연 발표 |
Pre-sewn Eight-branched Aortic Graft for Crawford Extent II Thoracoabdominal Aortic Aneurysm Repair
Hong Rae Kim¹, Sung Jun Park¹, Joon Bum Kim²
¹Department of Thoracic and Cardiovascular Surgery, Armed Forces Daegu Hospital, Daegu, Republic of Korea., ²Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : Reconstruction of the visceral and intercostal arteries is a challenging part of open surgical repair of extensive thoracoabdominal aortic aneurysm (TAAA). For more efficient reconstruction of these branching vessels, a technique of using pre-hand-sewn 8-branch aortic graft (octopod technique) was been adopted.
Methods : The octopod graft was constructed using commercially available two 4-branch aortic grafts connected each other before surgery. Besides 4 side-branches for revascularization of visceral and renal arteries, 3 branches were used for bypassing the segmental arteries while one side-branch was used for additional arterial inflow.
Results : From May 2015 through Feb 2017, 12 patients (median 37 yrs, range 24-53 yrs; 3 females) including 8 with Marfan syndrome underwent extent II TAA repair using the octopod technique. 10 patients had undergone prior proximal aorta repair including 2 patients undergoing redo-thoracotomy. As a result, 8 patients had completion of entire aorta replacement. 8 patients required circulatory arrest to include distal arch replacement. 4 patients underwent bi-iliac reconstruction. Intercostal artery revascularization was conducted in all patients (median N=2, range 1-3). Median pump and procedural times were 173 min (102-207min) and 437 min (343-489 min). There was no operative mortality or spinal cord injury. Major complications included re-exploration due to bleeding in 1, temporary renal replacement therapy in 2, prolonged ventilator support (>48hr) in 3. During follow-up (median 259 days, 43-652 days), 1 patient died of pre-existing heart failure (205 days).
Conclusion : The octopod technique for open TAAA repair showed excellent early and mid-term results with high procedural efficiency.
Methods : The octopod graft was constructed using commercially available two 4-branch aortic grafts connected each other before surgery. Besides 4 side-branches for revascularization of visceral and renal arteries, 3 branches were used for bypassing the segmental arteries while one side-branch was used for additional arterial inflow.
Results : From May 2015 through Feb 2017, 12 patients (median 37 yrs, range 24-53 yrs; 3 females) including 8 with Marfan syndrome underwent extent II TAA repair using the octopod technique. 10 patients had undergone prior proximal aorta repair including 2 patients undergoing redo-thoracotomy. As a result, 8 patients had completion of entire aorta replacement. 8 patients required circulatory arrest to include distal arch replacement. 4 patients underwent bi-iliac reconstruction. Intercostal artery revascularization was conducted in all patients (median N=2, range 1-3). Median pump and procedural times were 173 min (102-207min) and 437 min (343-489 min). There was no operative mortality or spinal cord injury. Major complications included re-exploration due to bleeding in 1, temporary renal replacement therapy in 2, prolonged ventilator support (>48hr) in 3. During follow-up (median 259 days, 43-652 days), 1 patient died of pre-existing heart failure (205 days).
Conclusion : The octopod technique for open TAAA repair showed excellent early and mid-term results with high procedural efficiency.
책임저자: Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Hong Rae Kim, E-mail : khrjsk@gmail.com