JTCS Click here to go to SJM website.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Goro Matsumiya
Masaaki Kato
Hiroshi Takano
Yoshiki Sawa
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shimamura, K.
Right arrow Articles by Sawa, Y.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Shimamura, K.
Right arrow Articles by Sawa, Y.
Related Collections
Right arrow Great vessels
Right arrowRelated Article

J Thorac Cardiovasc Surg 2008;135:1261-1269
© 2008 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Long-term results of the open stent-grafting technique for extended aortic arch disease

Kazuo Shimamura, MDa, Toru Kuratani, MD, PhDa, Goro Matsumiya, MD, PhDa, Masaaki Kato, MD, PhDd, Yukitoshi Shirakawa, MD, PhDa, Hiroshi Takano, MD, PhDc, Noriyuki Ohta, MD, PhDb, Yoshiki Sawa, MD, PhDa,*

a Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
b Department of Anesthesiology, Osaka University Graduate School of Medicine, Osaka, Japan
c Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, Japan
d Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan

Received for publication May 3, 2007; revisions received September 27, 2007; accepted for publication October 31, 2007.

* Address for reprints: Yoshiki Sawa, MD, PhD, Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. (Email: sawa{at}surg1.med.osaka-u.ac.jp).

Objective: This report elucidates the long-term safety and effectiveness of extended aortic arch replacement with an open stent-grafting technique from our 12 years of experience.

Methods: From 1994 to 2004, 126 patients (mean age 67.8 years) with different pathologic conditions of the aortic arch with extension to the descending aorta (57 dissections [acute/chronic = 31/26] and 69 aneurysms) were operated on with an open stent-grafting technique. During deep hypothermic circulatory arrest with selective cerebral perfusion, the stent graft was delivered through the transected proximal aortic arch, and arch replacement with a 4-branched prosthesis was performed.

Results: Operative mortality within 30 days was 3.2%. Perioperative morbidity included 7 (5.6%) strokes and 8 (6.3%) spinal injuries (paraplegia in 3, transient paraparesis in 5). Sixty-three percent of the patients were extubated within 24 hours. In long-term follow-up (mean 60.4 ± 36.5 months, maximum 153 months), survival was 81.1%, 63.3%, and 53.7% at 1, 5, and 8 years. Five (3.9%) late endoleaks were observed but treated with successful additional endovascular repair. Freedom from endoleaks was 98.0%, 91.1%, and 91.1% for 1, 5, and 8 years, respectively.

Conclusion: Long-term observation showed safety and good durability of the open stent-grafting technique for aortic arch disease. This technique could be an attractive treatment option for aortic arch aneurysm with distal extension and aortic dissection requiring aortic arch replacement.

Abbreviations and Acronyms CSFD = cerebrospinal fluid drainage; CT = computed tomography; TEVAR = thoracic endovascular aortic repair; Th = thoracic (vertebra)


Related Article

Discussion
J. Thorac. Cardiovasc. Surg. 2008 135: 1268-1269. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
K. Shimamura, T. Kuratani, G. Matsumiya, Y. Shirakawa, M. Takeuchi, H. Takano, and Y. Sawa
Hybrid endovascular aortic arch repair using branched endoprosthesis: The second-generation "branched" open stent-grafting technique
J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 46 - 53.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
N. Uchida and K. Akira
Reply to Glauber et al.
Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 922 - 922.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K.-H. Park, C. Lim, J. H. Choi, E. Chung, S. I. Choi, E. J. Chun, and K. Sung
Midterm Change of Descending Aortic False Lumen After Repair of Acute Type I Dissection
Ann. Thorac. Surg., January 1, 2009; 87(1): 103 - 108.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2008 by The American Association for Thoracic Surgery.