초록접수 현황
| 17F-033 | 구연 미채택시 포럼 발표 |
Thoracic Endovascular Aortic Repair (TEVAR) for Complicated Type B Aortic Dissection
Hong Chul Oh, Young Woo Park, Won Ho Chang
Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
Purpose : The aim of this study isto report a single center experience with TEVAR for type B dissection of thoracic aorta and to evaluate its feasibility and early outcome.
Methods : We reviewed 21 patients (16 men and 5 women, mean age 57.9 years; range 26-85 years) from August 2014 to July 2016 treated complicated type B aortic dissection by TEVAR. Indications for surgery included intractable pain not respond to medical treatment in 8 (38.1%), rupture in 6, limb ischemia in 6 (28.6%), hemothorax with impending rupture in 5, visceral malperfusion in 5 (23.8%) and transient paraplegia in one patient (4.8%). TEVAR were performed via a groin incision under general anesthesia. Follow up was 100% during a period 12 months.
Results : Mean interval period from aortic dissection to TEVAR was 248.14 days (range 0-3120 days). Technical success (sealing of tearing site) could be achieved in all patients. In-hospital mortality was none and one late rupture after discharge. All hemothoraces resolved after TEVAR including 3 patients required tube thoracostomy. All malperfusions were improved except one patient required adjunct distal stent. Morbidities included endoleak in 6 (28.6%), stroke in 3 (14.3%), pneumonia in 2, transient ischemia of left arm in 2 (9.5%) and temporary visceral ischemia in one patient (4.8%). Postoperative CT angiography showed complete thrombosis of false lumen in 17 patients (81.0%).
Conclusion : TEVAR for complicated type B aortic dissection with stent graft is technically feasible and effective with low morbidity and mortality rate. However, the long-term outcome and its efficacy needs to be evaluated further
Methods : We reviewed 21 patients (16 men and 5 women, mean age 57.9 years; range 26-85 years) from August 2014 to July 2016 treated complicated type B aortic dissection by TEVAR. Indications for surgery included intractable pain not respond to medical treatment in 8 (38.1%), rupture in 6, limb ischemia in 6 (28.6%), hemothorax with impending rupture in 5, visceral malperfusion in 5 (23.8%) and transient paraplegia in one patient (4.8%). TEVAR were performed via a groin incision under general anesthesia. Follow up was 100% during a period 12 months.
Results : Mean interval period from aortic dissection to TEVAR was 248.14 days (range 0-3120 days). Technical success (sealing of tearing site) could be achieved in all patients. In-hospital mortality was none and one late rupture after discharge. All hemothoraces resolved after TEVAR including 3 patients required tube thoracostomy. All malperfusions were improved except one patient required adjunct distal stent. Morbidities included endoleak in 6 (28.6%), stroke in 3 (14.3%), pneumonia in 2, transient ischemia of left arm in 2 (9.5%) and temporary visceral ischemia in one patient (4.8%). Postoperative CT angiography showed complete thrombosis of false lumen in 17 patients (81.0%).
Conclusion : TEVAR for complicated type B aortic dissection with stent graft is technically feasible and effective with low morbidity and mortality rate. However, the long-term outcome and its efficacy needs to be evaluated further
책임저자: Won Ho Chang
Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
발표자: Hong Chul Oh, E-mail : s89517@schmc.ac.kr