The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 6, Supplement , Pages S179-S184, December 2010

Long-term results of thoracic endovascular aortic repair in atherosclerotic aneurysms involving the descending aorta

  • Martin Czerny, MD

      Affiliations

    • Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland
  • ,
  • Martin Funovics, MD

      Affiliations

    • Department of Interventional Radiology, Medical University of Vienna, Vienna, Austria
  • ,
  • Gottfried Sodeck, MD

      Affiliations

    • Department of Cardiology, Krankenanstalt Rudolfstiftung, Vienna, Austria
  • ,
  • Julia Dumfarth, MD

      Affiliations

    • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
  • ,
  • Maria Schoder, MD

      Affiliations

    • Department of Interventional Radiology, Medical University of Vienna, Vienna, Austria
  • ,
  • Andrzej Juraszek, MS

      Affiliations

    • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
  • ,
  • Tomasz Dziodzio, MS

      Affiliations

    • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
  • ,
  • Daniel Zimpfer, MD

      Affiliations

    • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
  • ,
  • Christian Loewe, MD

      Affiliations

    • Department of Interventional Radiology, Medical University of Vienna, Vienna, Austria
  • ,
  • Johannes Lammer, MD

      Affiliations

    • Department of Interventional Radiology, Medical University of Vienna, Vienna, Austria
  • ,
  • Raphael Rosenhek, MD

      Affiliations

    • Department of Cardiology, Medical University of Vienna, Vienna, Austria
  • ,
  • Marek Ehrlich, MD

      Affiliations

    • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
  • ,
  • Michael Grimm, MD

      Affiliations

    • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
    • Corresponding Author InformationAddress for reprints: Michael Grimm, MD, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

Received 27 April 2010; received in revised form 31 May 2010; accepted 21 June 2010. published online 22 July 2010.

Objective

This study evaluated long-term results of thoracic endovascular aortic repair for atherosclerotic aneurysms involving descending aorta.

Methods

One hundred thirteen patients underwent thoracic endovascular aortic repair for this indication from 1996 to 2009. Mean follow-up was 54 ± 38 months (5–144 months). In-hospital mortality, neurologic injury, need for rerouting, occurrence of endoleaks and their treatment, and survival were recorded.

Results

In-hospital mortality was 5.3%. Transient neurologic injury rate was 2.6%. Previous rerouting was performed in 51%. Assisted early and late type I and III endoleak rates were 7.9% and 5.7%, respectively. Five percent of patients required late surgical conversion. Actuarial survivals were 86%, 60%, and 42% at 1, 5, and 10 years, respectively. Aorta-related actuarial survivals were 94%, 90%, and 83% at 1, 5, and 10 years, respectively. Cox regression analysis revealed higher number of prostheses as independent risk factor for early (hazard ratio, 5.38; 95% confidence interval, 1.68–42.37) and late (hazard ratio, 8.49; 95% confidence interval, 1.09–66.06) endoleak formation. Female sex (hazard ratio, 0.35; 95% confidence interval, 0.13–0.99), no arch involvement (hazard ratio, 0.21; 95% confidence interval, 0.05–0.08), and higher number of prostheses (hazard ratio, 7.95; 95% confidence interval, 1.36–46.58) affected survival.

Conclusions

Aorta-related survival is excellent among patients undergoing thoracic endovascular aortic repair for atherosclerotic aneurysms involving the descending aorta. Life-long surveillance remains mandatory, with early and late failure uncommon but still needing consideration. Thoracic endovascular aortic repair in this group of patients remains attractive and has now proven durability.

CTSNet classification: 26

Abbreviations and Acronyms: CI, confidence interval, HR, hazard ratio, TEVAR, thoracic endovascular aortic repair

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 Disclosures: Martin Czerny, Martin Funovics, Gottfried Sodeck, ulia Dumfarth, Maria Schoder, Andrzej Juraszek, Tomasz Dziodzio, Daniel Zimpfer, Christian Loewe, Johannes Lammer, Raphael Rosenhek, Marek Ehrlich, and Michael Grimm have nothing to disclose with regard to commercial support.

PII: S0022-5223(10)00680-X

doi:10.1016/j.jtcvs.2010.06.031

The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 6, Supplement , Pages S179-S184, December 2010