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Surgical conversion after thoracic endovascular aortic repair.
Ludovic Canaud1, Pierre Alric, Thomas Gandet
1Department of Thoracic and Cardiovascular Surgery, Arnaud de Villeneuve Hospital, Montpellier, France. ludoviccanaud@hotmail.com
The Journal of Thoracic and Cardiovascular Surgery
|March 15, 2011
Summary
Thoracic endovascular aortic repair (TEVAR) complications can necessitate open repair. Experienced teams can manage these conversions, but caution is advised in complex cases.
Area of Science:
- Cardiovascular Surgery
- Endovascular Interventions
- Thoracic Aortic Disease Management
Background:
- Thoracic endovascular aortic repair (TEVAR) has transformed thoracic aortic lesion treatment.
- Despite improved outcomes, serious complications may necessitate conversion to open repair.
Observation:
- Seven of 186 TEVAR patients (3.7%) required open repair due to complications like device failure, infection, or dissection.
- Open conversions involved various complex surgical procedures, including stent-graft explantation and aortic replacement.
Findings:
- The 30-day mortality for open conversion was 28%, with two deaths from stent-graft infections.
- No stroke, paraplegia, or renal failure occurred post-conversion.
- Mean follow-up of 21.4 months showed varied outcomes, with some patients experiencing adverse events.
Implications:
- TEVAR complications requiring open conversion can be managed by experienced teams.
- Caution is recommended for TEVAR in specific clinical or anatomical situations.
- Increasing TEVAR use will likely lead to more patients requiring surgical conversion.