Scott A. LeMaire, MD, Susan Y

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Presentation transcript:

Thoracic or Thoracoabdominal Approaches to Endovascular Device Removal and Open Aortic Repair Scott A. LeMaire, MD, Susan Y. Green, MPH, Jae Hyun Kim, MD, Aryan Sameri, BA, Jennifer L. Parenti, RN, Peter H. Lin, MD, Joseph Huh, MD, Joseph S. Coselli, MD The Annals of Thoracic Surgery Volume 93, Issue 3, Pages 726-733 (March 2012) DOI: 10.1016/j.athoracsur.2011.10.080 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Preoperative drawing and computed tomography images illustrating a thoracoabdominal aortic aneurysm caused by chronic dissection in a patient who previously underwent open graft replacement of the proximal descending thoracic aorta and endovascular repair of the distal descending thoracic aorta. (B) Repair involved partial removal of the stent-graft and extent III graft replacement of the thoracoabdominal aorta. The Annals of Thoracic Surgery 2012 93, 726-733DOI: (10.1016/j.athoracsur.2011.10.080) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Preoperative drawing and computed tomography images illustrating a thoracoabdominal aortic aneurysm caused by chronic dissection in a patient who previously underwent replacement of the aortic root, ascending aorta, and aortic arch, followed by endovascular repair of the descending thoracic aorta using the elephant trunk graft as the proximal landing zone. (B) Repair involved complete removal of the stent-grafts and extent II graft replacement of the thoracoabdominal aorta. The Annals of Thoracic Surgery 2012 93, 726-733DOI: (10.1016/j.athoracsur.2011.10.080) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Computed tomography image of a patient with device infection and an aortoesophageal fistula. Gas can be seen around the edges of the endograft. The Annals of Thoracic Surgery 2012 93, 726-733DOI: (10.1016/j.athoracsur.2011.10.080) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Computed tomography images showing extremely rapid aortic expansion during the month after endovascular thoracic aortic repair in a 33-year-old patient with Marfan syndrome and chronic aortic dissection. Twenty-one days elapsed between the (A) first and (B) second scans. The Annals of Thoracic Surgery 2012 93, 726-733DOI: (10.1016/j.athoracsur.2011.10.080) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Kaplan-Meier curve showing late survival estimates for 35 patients after endovascular device removal and open aortic repair. The Annals of Thoracic Surgery 2012 93, 726-733DOI: (10.1016/j.athoracsur.2011.10.080) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions