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Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients
BACKGROUND: Endovascular technology now permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results. The long-term durability of such stent grafts is unknown, leading to concerns regarding their use in younger patients. This study...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269840/ https://www.ncbi.nlm.nih.gov/pubmed/25491157 http://dx.doi.org/10.1186/s13019-014-0195-4 |
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author | Johns, Neil Jamieson, Russell W Ceresa, Carlo Moores, Carl Nimmo, Alastair F Falah, Orwa Burns, Paul J Chalmers, Roderick TA |
author_facet | Johns, Neil Jamieson, Russell W Ceresa, Carlo Moores, Carl Nimmo, Alastair F Falah, Orwa Burns, Paul J Chalmers, Roderick TA |
author_sort | Johns, Neil |
collection | PubMed |
description | BACKGROUND: Endovascular technology now permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results. The long-term durability of such stent grafts is unknown, leading to concerns regarding their use in younger patients. This study reports contemporary outcomes of open repair in young patients. METHODS: Outcomes for patients age 60 or younger undergoing open TAAA repair between June 1999 and August 2013 with prospective collected data were analysed retrospectively. RESULTS: Thirty-seven patients (31 men, 84%) with a median age of 56 (range 22–60) were identified with a median TAAA diameter of 6.9 cm (range 5.6-11). Aneurysm aetiology included degenerative change (18), dilation of chronic dissection (10), connective tissue disease (7) and mycotic degeneration (2). Crawford Type IV TAAA were most commonly treated (17), followed by Type II (10), Type III (7) and Type I (3). Two (5%) patients died in hospital, one from multiple organ failure and one from respiratory failure. Three patients (8%) developed temporary paraplegia, all of whom made a complete recovery and 4 (11%) patients required temporary renal replacement therapy. Median critical care stay was 5 days (range 2–28) with an in-hospital stay of 14 days (range 7–83). During a median follow-up of 72 months (range 13–171), no patient subsequently required any further aneurysm related surgical or radiological intervention. The mean (SEM) survival time was 138.5 (11) months. The 5 year survival was 79.7% (8.3) including early deaths, with no aneurysm related complications. CONCLUSIONS: The outcome of open TAAA repair in patients aged less than 60 years is favorable. It is against these results that evolving endovascular interventions must be compared. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-014-0195-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4269840 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42698402014-12-18 Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients Johns, Neil Jamieson, Russell W Ceresa, Carlo Moores, Carl Nimmo, Alastair F Falah, Orwa Burns, Paul J Chalmers, Roderick TA J Cardiothorac Surg Research Article BACKGROUND: Endovascular technology now permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results. The long-term durability of such stent grafts is unknown, leading to concerns regarding their use in younger patients. This study reports contemporary outcomes of open repair in young patients. METHODS: Outcomes for patients age 60 or younger undergoing open TAAA repair between June 1999 and August 2013 with prospective collected data were analysed retrospectively. RESULTS: Thirty-seven patients (31 men, 84%) with a median age of 56 (range 22–60) were identified with a median TAAA diameter of 6.9 cm (range 5.6-11). Aneurysm aetiology included degenerative change (18), dilation of chronic dissection (10), connective tissue disease (7) and mycotic degeneration (2). Crawford Type IV TAAA were most commonly treated (17), followed by Type II (10), Type III (7) and Type I (3). Two (5%) patients died in hospital, one from multiple organ failure and one from respiratory failure. Three patients (8%) developed temporary paraplegia, all of whom made a complete recovery and 4 (11%) patients required temporary renal replacement therapy. Median critical care stay was 5 days (range 2–28) with an in-hospital stay of 14 days (range 7–83). During a median follow-up of 72 months (range 13–171), no patient subsequently required any further aneurysm related surgical or radiological intervention. The mean (SEM) survival time was 138.5 (11) months. The 5 year survival was 79.7% (8.3) including early deaths, with no aneurysm related complications. CONCLUSIONS: The outcome of open TAAA repair in patients aged less than 60 years is favorable. It is against these results that evolving endovascular interventions must be compared. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-014-0195-4) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-10 /pmc/articles/PMC4269840/ /pubmed/25491157 http://dx.doi.org/10.1186/s13019-014-0195-4 Text en © Johns et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. 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. |
spellingShingle | Research Article Johns, Neil Jamieson, Russell W Ceresa, Carlo Moores, Carl Nimmo, Alastair F Falah, Orwa Burns, Paul J Chalmers, Roderick TA Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
title | Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
title_full | Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
title_fullStr | Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
title_full_unstemmed | Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
title_short | Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
title_sort | contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269840/ https://www.ncbi.nlm.nih.gov/pubmed/25491157 http://dx.doi.org/10.1186/s13019-014-0195-4 |
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