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Authors
Shiraya, Suguru Division of Cardiovascular Surgery, Tottori University Faculty of Medicine KAKEN
Nakamura, Yoshinobu Division of Cardiovascular Surgery, Tottori University Faculty of Medicine Researchers DB KAKEN
Harada, Shingo Division of Cardiovascular Surgery, Tottori University Faculty of Medicine Researchers DB KAKEN
Kishimoto, Yuichiro Division of Cardiovascular Surgery, Tottori University Faculty of Medicine Researchers DB KAKEN
Onohara, Takeshi Division of Cardiovascular Surgery, Tottori University Faculty of Medicine
Otsuki, Yuki Division of Cardiovascular Surgery, Tottori University Faculty of Medicine Researchers DB
Kurashiki, Tomohiro Division of Cardiovascular Surgery, Tottori University Faculty of Medicine
Horie, Hiromu Division of Cardiovascular Surgery, Tottori University Faculty of Medicine Researchers DB
Nishimura, Motonobu Division of Cardiovascular Surgery, Tottori University Faculty of Medicine Researchers DB KAKEN
Keywords
Debranching TEVAR
Thoracic aortic aneurysm in the elderly
Distal arch aneurysm
Abstract
Background: We examined the outcome of debranching thoracic endovascular aortic repair (d-TEVAR) without sternotomy for distal aortic arch aneurysm in patients aged ≥75 years. Methods: Patients who underwent d-TEVAR or TAR for aortic arch aneurysm between 2008 and 2015 at our hospital and aged ≥75 years were included. Age, sex, left ventricular ejection fraction, preoperative creatinine level, diabetes, cerebrovascular disease, and chronic obstructive pulmonary disease were matched using PS. Results: Among 74 patients (d-TEVAR: 51, TAR: 23), 17 patients in each group were matched. No difference in surgical outcome was detected between the d-TEVAR and TAR groups, including 30-day death (0% vs. 0%), hospital death (5.8% vs. 0%: p = 0.31) and incidence of cerebral infarction (5.8% vs. 7.6%: p = 0.27) as well as the long-term outcomes of 5-year survival (92.8% vs. 74.8%: p = 0.30) and 5-year aorta-related event-free rate (88.2% vs. 100%: p = 0.15). Average duration of ICU stay (1.3 ± 1.1 days vs. 5.6 ± 1.3 days: p = 0.025) and hospital stay (16.5 ± 5.2 days vs. 37.7 ± 19.6 days: p = 0.017) were significantly shorter in the d-TEVAR group. Conclusion: Our results indicated that d-TEVAR is less invasive without affecting long-term outcome up to 5 years. Although the number of the patients included in the study was small, debranching TEVAR could be one of the treatments of the choice in the elderly, especially with comorbidities.
Publisher
BioMed Central Ltd.
Content Type
Journal Article
Link
EISSN
17498090
Journal Title
JOURNAL OF CARDIOTHORACIC SURGERY
Current Journal Title
JOURNAL OF CARDIOTHORACIC SURGERY
Volume
15
Published Date
2020-01-10
Publisher-DOI
Text Version
Publisher
Rights
© The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Citation
Shiraya Suguru, Nakamura Yoshinobu, Harada Shingo, et al. Debranching thoracic endovascular aortic repair for distal aortic arch aneurysm in elderly patients aged over 75 years old. JOURNAL OF CARDIOTHORACIC SURGERY. 2020. 15(1). doi:10.1186/s13019-020-1047-z
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English
Web of Science Key ut
WOS:000521283600002