Anthony L. Estrera, MD, Charles C

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Presentation transcript:

Determinants of early and late outcome for reoperations of the proximal aorta Anthony L. Estrera, MD, Charles C. Miller, PhD, Eyal Porat, MD, Shafi Mohamed, MD, Robert Kincade, MD, Tam T. Huynh, MD, Hazim J. Safi, MD The Annals of Thoracic Surgery Volume 78, Issue 3, Pages 837-845 (September 2004) DOI: 10.1016/j.athoracsur.2004.03.085

Fig 1 Typical case for reoperation: dissection and extensive aortic aneurysm after coronary artery bypass grafting. Computed tomographic scans of the ascending and transverse arch are depicted. The Annals of Thoracic Surgery 2004 78, 837-845DOI: (10.1016/j.athoracsur.2004.03.085)

Fig 2 (A) The redo sternotomy is completed in stages as adhesions are cut from the undersurface of the sternum. (B) The completed sternotomy. Arrows indicate direction of applied retraction. The Annals of Thoracic Surgery 2004 78, 837-845DOI: (10.1016/j.athoracsur.2004.03.085)

Fig 3 Modified elephant trunk: a separate Dacron graft is inserted into the descending thoracic aorta and sutured distal to the left subclavian artery (left). The ascending and transverse arch aorta is repaired with a separate graft (right). The Annals of Thoracic Surgery 2004 78, 837-845DOI: (10.1016/j.athoracsur.2004.03.085)

Fig 4 (A) Fenestration of a dissected aorta. (B) Fenestration completed. The Annals of Thoracic Surgery 2004 78, 837-845DOI: (10.1016/j.athoracsur.2004.03.085)

Fig 5 (A) Single button reattachment of saphenous vein bypass grafts. (B) Individual Cabrol interposition grafts. (C) Saphenous vein grafts reattached to a single interposition graft. (D) Interposition saphenous vein grafts. The Annals of Thoracic Surgery 2004 78, 837-845DOI: (10.1016/j.athoracsur.2004.03.085)

Fig 6 (A) Kaplan-Meier diagram, overall disease-free 10-year survival. (B) Kaplan-Meier diagram, overall disease-free 10-year survival in patients with renal dysfunction. (Dysf = dysfunction; Pre-op = preoperative.) (C) Kaplan-Meier diagram, overall disease-free 10-year survival in patients with chronic obstructive pulmonary disease (COPD). The Annals of Thoracic Surgery 2004 78, 837-845DOI: (10.1016/j.athoracsur.2004.03.085)