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[Total aortic arch replacement for severe atherosclerotic aortic aneurysms;consecutive 135 cases study]
Kazuo Yamanaka1, Takeshi Nishina, Naoki Kanemitsu
1Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|October 10, 2013
Summary
This study validates surgical procedures for total aortic arch replacement based on aortic arch atherosclerosis. While stroke rates were acceptable, further improvements in stroke prevention are necessary for this complex surgery.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Medical Imaging
Background:
- Thoracic aortic aneurysms require complex surgical repair, such as total aortic arch replacement (TAR).
- The degree of atherosclerosis in the aortic arch can influence surgical strategy and outcomes.
- Preoperative assessment of aortic arch atherosclerosis is crucial for planning TAR procedures.
Purpose of the Study:
- To evaluate the validity of surgical procedures for total aortic arch replacement (TAR).
- To assess the impact of aortic arch atherosclerosis on surgical outcomes.
- To compare outcomes between patients with different degrees of aortic arch atherosclerosis undergoing TAR.
Main Methods:
- A retrospective study of 135 patients undergoing TAR for thoracic aortic aneurysms between 2007 and 2013.
- Atherosclerosis was assessed using preoperative CT scans and intraoperative epiaortic echocardiography.
- Patients were divided into two groups based on atherosclerosis severity: mild/moderate (G1) and severe (G2), with different arterial cannulation sites used.
Main Results:
- No significant differences in mortality or neurological events between groups.
- Higher rates of stroke occurred in patients with severe atherosclerosis.
- Patients with severe atherosclerosis experienced longer operation times, ICU stays, and hospital stays.
Conclusions:
- Surgical procedures for TAR can be selected based on aortic arch atherosclerosis.
- The overall stroke rate in this study was acceptable.
- Further improvements are needed in stroke prevention strategies for patients undergoing TAR, particularly those with severe atherosclerosis.
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