| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2005;27:826-830
© 2005 Elsevier Science NL
Department of Cardiothoracic and Respiratory Sciences, Division of Cardiovascular Surgery and Transplants, Second University of Naples, V Monaldi Hospital, 80131 Naples, Italy
Received 17 September 2004; received in revised form 24 January 2005; accepted 2 February 2005.
* Corresponding author. Address: Via Simone Martini, 76, Naples 80128, Italy. Tel.: +39 81 579 3001; fax: +39 81 546 4594. (E-mail: gdial{at}libero.it).
Objective: To evaluate the mid-term results of endovascular stent-grafting for type B aortic dissection, in comparison with those of standard medical therapy in uncomplicated cases. Methods: Between January 1999 and 2004, among 56 patients (mean age 59.5±11.5 years) with type B aortic dissection, hypotensive medical therapy was the only treatment in 28 uncomplicated cases, (group A), while stent-graft implantation was performed in 28 patients with uncontrolled hypertension, persistent pain or evidence of dissection progression or complication (group B). In 14 cases (50%) the procedure was performed in an acute setting. Stent-grafting procedures were monitored with intraoperative trans-esophageal echocardiography and cine-angiography. CT scan and trans-esophageal echocardiography were performed before hospital discharge, at 6 and 12 months and then yearly. Results: Follow-up (range 1–61 months, average 18.1±16.9 months) was 100% complete. In-hospital mortality was 10.7% (three patients, all belonging to Group B; P=0.24). No spinal cord injuries were observed. Early endoleak occurred in one patient (3.5%). Mid-term mortality was lower in Group B, although the difference was not significant (10.7 versus 14.3% in Group A, P=0.71). Follow-up CT scans evidenced complete thrombosis of the false lumen in 75% cases in Group B, 10.7% in Group A (P=0.0001), and an aneurismal dilatation of the descending aorta in 3.5% cases in Group B, 28.5% in Group A (P=0.02). Conclusions: Although with still considerable early mortality, endovascular stent-graft implantation is an effective option for the treatment of complicated type B aortic dissection. Endovascular treatment achieved a better mid-term fate of the descending thoracic aorta than medical therapy alone, even in patients with worse preoperative conditions.
Key Words: Descending aorta • Aortic dissection • Endovascular stent-graft • Hypotensive therapy
This article has been cited by other articles:
|
|
 |
|
  A. Pochettino, W. T. Brinkman, P. Moeller, W. Y. Szeto, W. Moser, K. Cornelius, F. W. Bowen, Y. J. Woo, and J. E. Bavaria Antegrade thoracic stent grafting during repair of acute DeBakey I dissection prevents development of thoracoabdominal aortic aneurysms. Ann. Thorac. Surg., August 1, 2009; 88(2): 482 - 489. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. D. Patel and R. R. Arora Pathophysiology, diagnosis, and management of aortic dissection Therapeutic Advances in Cardiovascular Disease, December 1, 2008; 2(6): 439 - 468. [Abstract] [PDF]
|
|
|
|
|
|
J. D. Parker and J. Golledge Outcome of Endovascular Treatment of Acute Type B Aortic Dissection Ann. Thorac. Surg., November 1, 2008; 86(5): 1707 - 1712. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Swee and M. D. Dake Endovascular Management of Thoracic Dissections Circulation, March 18, 2008; 117(11): 1460 - 1473. [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 |
