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Outcomes of open surgical repair for chronic type B aortic dissections

Allan M Conway1, Mostafa Sadek1, Joanelle Lugo1

  • 1Lenox Hill Heart and Vascular Institute of New York, Lenox Hill Hospital, North Shore-LIJ Health System, New York, NY.

Journal of Vascular Surgery
|January 16, 2014
PubMed

Insights

Open surgical repair (OSR) for chronic type B aortic dissection (CTBAD) is a durable treatment with low mortality. High-risk patients may benefit from further evaluation for thoracic endovascular aortic repair (TEVAR).

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Open surgical repair (OSR) for chronic type B aortic dissection (CTBAD) carries significant risks.
  • The efficacy of thoracic endovascular aortic repair (TEVAR) for CTBAD remains uncertain.
  • Identifying high-risk CTBAD patients is crucial for treatment selection.

Purpose of the Study:

  • To analyze the outcomes of OSR in CTBAD patients.
  • To identify predictors of mortality and complications after OSR for CTBAD.
  • To evaluate the suitability of OSR as a durable option for CTBAD.

Main Methods:

  • Retrospective analysis of 221 patients undergoing thoracic or thoracoabdominal aortic aneurysm repair from 1999-2010.
  • Focus on 86 patients with CTBAD treated with OSR.
  • Data collected included mortality, complications, length of stay, and reinterventions.

Main Results:

  • Hospital mortality was 5.8% for OSR in CTBAD.
  • Major complications included paraplegia, stroke, and renal failure (2.3% each).
  • Overall survival at 7 years was 70%, with 86% freedom from reoperation.

Conclusions:

  • OSR is a durable treatment for CTBAD with acceptable mortality rates.
  • Redo operations and prolonged cardiopulmonary bypass time were predictors of mortality.
  • Further evaluation is needed to determine optimal treatment strategies, including TEVAR, for high-risk CTBAD patients.
Abstract

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