Antegrade thoracic stent grafting during repair of acute Debakey type I dissection promotes distal aortic remodeling and reduces late open distal reoperation rate

The Journal of Thoracic and Cardiovascular Surgery
Prashanth VallabhajosyulaJoseph E Bavaria

Abstract

Previously, we showed that antegrade stent grafting of the descending thoracic aorta during DeBakey type I dissection repair improves distal aortic remodeling. We assessed midterm outcomes of this reconstructive strategy compared with standard open repair. DeBakey type I dissections (non-Marfan, nontotal arch cases only) from 2005 to 2012 were retrospectively reviewed. One hundred eighty patients underwent standard open repair (standard group), and 62 patients underwent open repair plus stenting (stented group). Open repair entailed ascending aorta plus transverse hemiarch reconstruction under circulatory arrest, with variable aortic root work. Data was prospectively maintained. Preoperative parameters were similar. Patients in the stented group had longer circulatory arrest time and higher utility of antegrade cerebral perfusion (P < .001). In-hospital/30-day mortality (10% vs 14%; P = .51), stroke (5% vs 8%; P = .6), and paraplegia (0% vs 1%; P = 1) were similar in the stented versus standard groups. Mean follow-up was 2.7 ± 2.3 and 2.2 ± 2.1 years. Actuarial survival in stented versus standard groups at 1 and 7 years was 86% versus 81% and 76% versus 60% (P = .5). Thoracic aorta false lumen obliteration was improved in the s...Continue Reading

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Citations

Jan 23, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hung-Lung HsuJer-Shen Chen
Nov 26, 2015·The Canadian Journal of Cardiology·Ismail El-HamamsyUNKNOWN Canadian Thoracic Aortic Collaborative (CTAC)
Oct 31, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Prashanth VallabhajosyulaJoseph E Bavaria
Sep 13, 2014·The Journal of Thoracic and Cardiovascular Surgery·Joseph S CoselliScott A LeMaire
Jul 24, 2015·Journal of Cardiac Surgery·Fabrizio SettepaniGiuseppe Tarelli
May 20, 2015·The Journal of Thoracic and Cardiovascular Surgery·Prashanth Vallabhajosyula, Wilson Y Szeto
Mar 31, 2015·The Journal of Thoracic and Cardiovascular Surgery·Wilson Y Szeto
Sep 27, 2016·The Annals of Thoracic Surgery·Prashanth VallabhajosyulaJoseph E Bavaria
Jan 8, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Peter MattFriedrich Eckstein
Mar 2, 2019·Interactive Cardiovascular and Thoracic Surgery·Boris N KozlovVladimir M Shipulin
Jan 4, 2017·Interactive Cardiovascular and Thoracic Surgery·Holly N SmithJehangir J Appoo
Aug 14, 2019·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Lixin WangWeiguo Fu
Jan 22, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Roberto Di BartolomeoDavide Pacini
Nov 4, 2020·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Joshua C Grimm, Joseph E Bavaria
Aug 25, 2020·The Annals of Thoracic Surgery·William T Brinkman
Feb 10, 2021·The Journal of Thoracic and Cardiovascular Surgery·Christopher LauLeonard N Girardi
Mar 25, 2021·Seminars in Vascular Surgery·Indrani SenRandall R DeMartino
Oct 24, 2020·The Annals of Thoracic Surgery·Jing ZhangWei Zhang
Jul 17, 2021·Current Cardiology Reports·Patrick R VargoEric E Roselli
Apr 18, 2020·The Journal of Thoracic and Cardiovascular Surgery·Keiji UchidaUNKNOWN Yokohama City University CVS Group
Mar 3, 2020·The Journal of Thoracic and Cardiovascular Surgery·Dawn S Hui
Apr 9, 2019·The Journal of Thoracic and Cardiovascular Surgery·Ourania PreventzaJoseph S Coselli
Dec 2, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Koji KawahitoHideo Adachi

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