Hybrid Debranching With Endovascular Repair for Thoracoabdominal Aneurysms: A Comparison With Open Repair Himanshu J. Patel, MD, Gilbert R. Upchurch,

Slides:

Advertisements

Similar presentations

Results of Coronary Artery Endarterectomy and Coronary Artery Bypass Grafting for Diffuse Coronary Artery Disease Srikrishna Sirivella, MD, Isaac Gielchinsky,

Advertisements

Elevated Preoperative Hemoglobin A1c Level is Associated With Reduced Long-Term Survival After Coronary Artery Bypass Surgery Michael E. Halkos, MD,

Darrell Wu, MD, Matt D. Price, MS, Hiruni S. Amarasekara, MS, Susan Y

Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes John E. Jones, MD, Marvin.

Jordan Knepper, MD, Enrique Criado, MD Journal of Vascular Surgery

Rana O. Afifi, MD, Harleen K. Sandhu, MD, MPH, Amy. E

Open Distal Fenestration of Chronic Dissection Facilitates Endovascular Elephant Trunk Completion: Late Outcomes Muhammad Aftab, MD, Jay J. Idrees, MD,

Magnitude of Negative Impact of Preoperative Heart Failure on Mortality During Aortic Valve Replacement in the Medicare Population Christina M. Vassileva,

The challenge of associated intramural hematoma with endovascular repair for penetrating ulcers of the descending thoracic aorta Himanshu J. Patel, MD,

Outcomes of Reintervention on the Autograft After Ross Procedure

Endovascular treatment of thoracoabdominal aortic aneurysms

Outcome of thoracic endovascular aortic repair in patients with thoracic and thoracoabdominal aortic aneurysms Moritz S. Bischoff, MD, Marius Ante, MD,

Late Outcomes With Repair of Penetrating Thoracic Aortic Ulcers: The Merits of an Endovascular Approach Himanshu J. Patel, MD, Vikram Sood, BS, David.

Hancock II Bioprosthesis for Aortic Valve Replacement: The Gold Standard of Bioprosthetic Valves Durability? Tirone E. David, MD, Susan Armstrong, MS,

Lisa M. Brown, MD, MAS, David T. Cooke, MD, Elizabeth A. David, MD

Risk of Spinal Cord Injury After Operations of Recurrent Aneurysms of the Descending Aorta Jorge Flores, MD, Norihiko Shiiya, MD, PhD, Takashi Kunihara,

Dhaval Chauhan, MD, Alexis K

Impact of Preoperative Renal Dysfunction on Long-Term Survival for Patients Undergoing Aortic Valve Replacement Vinod H. Thourani, MD, W. Brent Keeling,

Michael E. Halkos, MD, Patrick Kilgo, MS, Omar M

The Impact of Specific Preoperative Organ Dysfunction in Patients Undergoing Aortic Valve Replacement Vinod H. Thourani, MD, Ritam Chowdhury, MD, Rebecca.

Elevated Preoperative Hemoglobin A1c Level is Associated With Reduced Long-Term Survival After Coronary Artery Bypass Surgery Michael E. Halkos, MD,

Michael L. Bailey, MBBS, Sven M. Richter, MD, Daniel V

Operative Results and Outcomes in Children With Shone's Anomaly

Joseph S. Coselli, MD, Susan Y. Green, MPH, Matt D

Himanshu J. Patel, MD, David M. Williams, MD, Gilbert R

Total Arch Replacement With Stented Elephant Trunk Technique for Acute Type B Aortic Dissection Involving the Aortic Arch Hai-Peng Zhao, MD, Jun-Ming.

Risk Modeling to Optimize Patient Selection for Management of the Descending Thoracic Aortic Aneurysm Akiko Tanaka, MD, PhD, Harleen K. Sandhu, MD, MPH,

Joseph S. Coselli, MD, Hiruni S. Amarasekara, MS, Susan Y

Darrell Wu, MD, Matt D. Price, MS, Hiruni S. Amarasekara, MS, Susan Y

Options for repair of a bicuspid aortic valve and ascending aortic aneurysm Thoralf M Sundt, MD, Bassem N Mora, MD, Marc R Moon, MD, Marci S Bailey, MSN,

Asad A. Shah, MD, Mathias Worni, MD, MHS, Christopher R

Endovascular abdominal aortic aneurysm repair: Long-term outcome measures in patients at high-risk for open surgery Gregorio A. Sicard, MD, Robert M.

Orthotopic Heart Transplantation in Patients With Marfan Syndrome

The natural history of type II endoleaks after endovascular aneurysm repair for ruptured abdominal aortic aneurysm Anna E. Boniakowski, MD, Randall R.

Bo Yang, MD, PhD, Himanshu J. Patel, MD, Claire Sorek, BS, Whitney E

Ross Versus Non-Ross Aortic Valve Replacement in Children: A 22-Year Single Institution Comparison of Outcomes John W. Brown, MD, Parth M. Patel, BS,

Comparison of attachment site endoleak rates in Dacron versus native aorta landing zones after thoracic endovascular aortic repair Asvin M. Ganapathi,

Use of Amiodarone After Major Lung Resection

Impact of Blood Product Transfusion on Short and Long-Term Survival After Cardiac Surgery: More Evidence Balu Bhaskar, MD, FCICM, Joel Dulhunty, PhD,

Outcome of thoracic endovascular aortic repair in patients with thoracic and thoracoabdominal aortic aneurysms Moritz S. Bischoff, MD, Marius Ante, MD,

Hybrid aortic arch repair for complicated type B aortic dissection

Aortic Valve Replacement and Concomitant Coronary Artery Bypass: Assessing the Impact of Multiple Grafts Kimiyoshi J. Kobayashi, BS, Jason A. Williams,

Natural History of Ascending Aortic Aneurysms in the Setting of an Unreplaced Bicuspid Aortic Valve Ryan R. Davies, MD, Ryan K. Kaple, BA, Divakar Mandapati,

Kathryn E. Engelhardt, MD, Malcolm M. DeCamp, MD, Anthony D

Eric S. Weiss, MD, MPH, Jeremiah G. Allen, MD, Christian A

Cardiac Arrhythmia After Open Thoracoabdominal Aortic Aneurysm Repair

David H. Stone, MD, David C. Brewster, MD, Christopher J

Daniel R. Wong, MD, MPH, Joseph S

Pretransplant Panel Reactive Antibodies in Human Lung Transplantation: An Analysis of Over 10,000 Patients Ashish S. Shah, MD, Lois Nwakanma, MD, Christopher.

Surgical Outcomes of Chronic Descending Dissections: Type I Versus III DeBakey Ivancarmine Gambardella, MD, FRCS, Mario Gaudino, MD, Christopher Lau,

John W. Brown, MD, Mark Ruzmetov, MD, PhD, Mark H. Hoyer, MD, Mark D

Iliofemoral complications associated with thoracic endovascular aortic repair: Frequency, risk factors, and early and late outcomes Frank C. Vandy, MD,

Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass

Surgical treatment of intact thoracoabdominal aortic aneurysms in the United States: Hospital and surgeon volume-related outcomes John A Cowan, MD, Justin.

Repair of Thoracoabdominal Aortic Aneurysms in Octogenarians

Results of Thoracic Endovascular Aortic Repair 6 Years After United States Food and Drug Administration Approval Asad A. Shah, MD, Michael E. Barfield,

Trends in Patient Characteristics and Outcomes of Coronary Artery Bypass Grafting in the 2000 to 2012 Medicare Population Christian McNeely, MD, Stephen.

Endovascular Treatment of Type B Aortic Dissection: The Challenge of Late Success Claudia Maria Rodrigues Alves, MD, PhD, José Honório Palma da Fonseca,

The Impact of Volume Reduction on Early and Long-Term Outcomes in Surgical Ventricular Restoration for Severe Heart Failure Nathan Wm. Skelley, BS, Jeremiah.

The Impact of Acute Renal Failure on Early and Late Outcomes After Thoracic Aortic Endovascular Repair Joseph D. Drews, BS, Himanshu J. Patel, MD, David.

Stefano Zoli, MD, Christian D

Steve K. Singh, MD, Gilbert H. L. Tang, MD, Manjula D

Creation of a Quantitative Score to Predict the Need for Mechanical Support in Children Awaiting Heart Transplant Ryan R. Davies, MD, Shylah Haldeman,

Thoracic aortic endovascular repair for mycotic aneurysms and fistulas

Right Minithoracotomy Versus Full Sternotomy for Mitral Valve Repair: A Propensity Matched Comparison Rüdiger Lange, MD, PhD, Bernhard Voss, MD, Victoria.

Xiaoying Lou, MD, Edward P. Chen, MD, Yazan M. Duwayri, MD, Ravi K

Dumbor L. Ngaage, MD, FRCS (C-Th), Michael E. Cowen, FRCS

Justin P. V. Zachariah, MD, Frank A. Pigula, MD, John E

Slide Tracheoplasty in Infants and Children: Risk Factors for Prolonged Postoperative Ventilatory Support Peter B. Manning, MD, Michael J. Rutter, MD,

Risk of Valve-Related Events After Aortic Valve Repair

Presentation transcript:

Hybrid Debranching With Endovascular Repair for Thoracoabdominal Aneurysms: A Comparison With Open Repair Himanshu J. Patel, MD, Gilbert R. Upchurch, MD, Jonathan L. Eliason, MD, Enrique Criado, MD, John Rectenwald, MD, David M. Williams, MD, G. Michael Deeb, MD The Annals of Thoracic Surgery Volume 89, Issue 5, Pages 1475-1481 (May 2010) DOI: 10.1016/j.athoracsur.2010.01.062 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Kaplan-Meier survival analysis comparing conventional open thoracoabdominal aneurysm repair (TAAA) to hybrid debranching repair. This actuarial analysis demonstrates that after either open or hybrid debranching thoracoabdominal aortic repair, there is no significant difference in Kaplan-Meier survival (mean survival open repair, 75 months versus hybrid debranching and thoracic endovascular repair, 81.1 months; p = 0.88). The Annals of Thoracic Surgery 2010 89, 1475-1481DOI: (10.1016/j.athoracsur.2010.01.062) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Impact of diabetes on late survival. Diabetes was identified as an important independent predictor of late mortality (p = 0.052, odds ratio 4.5). This actuarial analysis demonstrates the significant time-dependent effects of diabetes on late survival, with 3-year survival in diabetic patients at 40% versus 80% for nondiabetics. (B) Impact of postoperative need for dialysis on late survival. The postoperative need for dialysis was an independent risk factor for late mortality on multivariate analysis (p < 0.001, odds ratio 8.6). This Kaplan-Meier analysis identifies decreased late survival in patients who underwent thoracoabdominal aortic aneurysm repair and had a postoperative dialysis (p < 0.001). The 3-year survival is 87.1% for those without a postoperative need for dialysis versus 32.8% for those requiring postoperative dialysis (p < 0.001). The Annals of Thoracic Surgery 2010 89, 1475-1481DOI: (10.1016/j.athoracsur.2010.01.062) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Freedom from need for aortic reintervention or aortic rupture. By Kaplan-Meier analysis, the mean freedom from treatment failure (defined as need for reintervention or rupture) for the entire cohort was 91.6 ± 5.9 months (data not shown). When the analysis was stratified by type of repair there was no difference between groups. The 4-year freedom from treatment failure was 90.5 ± 4.7% for the open thoracoabdominal aortic aneurysm repair group versus 92.0 ± 5.4% for the hybrid debranching group (p = 0.41). The Annals of Thoracic Surgery 2010 89, 1475-1481DOI: (10.1016/j.athoracsur.2010.01.062) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions