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15-03-2024 | Aortic Dissection | Original Article

Surgical Treatment for Type A Aortic Dissection after Endovascular Aortic Repair: A 12-year, Single-Center Study

Authors: Yuan Xue, Shipan Wang, Xuehuan Zhang, Xiaomeng Wang, Yue Shi, Hongjia Zhang, Duanduan Chen, Haiyang Li

Published in: Cardiovascular Drugs and Therapy

Abstract

Objective

This study aims to investigate the clinical manifestations, operative techniques, and outcomes of patients who undergo open repair after thoracic endovascular aortic repair (TEVAR).

Methods

From January 2010 to June 2022, 113 consecutive type A aortic dissection (TAAD) patients underwent secondary open operation after TEVAR at our institution, and the median interval from primary intervention to open surgery was 12 (1.9–48.0) months. We divided the patients into two groups (RTAD (retrograde type A dissection) group, N = 56; PNAD (proximal new aortic dissection) group, N = 57) according to their anatomical features. Survival analysis during the follow-up was evaluated using a Kaplan–Meier survival curve and a log-rank test.

Results

The 30-day mortality was 6.2% (7/113), the median follow-up period was 31.7 (IQR 14.7–65.6) months, and the overall survival at 1 year, 5 years, and 10 years was 88.5%, 88.5%, and 87.6%, respectively. Fourteen deaths occurred during the follow-up, but there were no late aorta-related deaths. Three patients underwent total thoracoabdominal aortic replacement 1 year after a second open operation. The RTAD group had a smaller ascending aorta size (42.5 ± 7.7 mm vs 48.4 ± 11.4 mm; P < .01) and a closer proximal landing zone (P < .01) compared to the PNAD group. However, there were no differences in survival between the two groups.

Conclusions

TAAD can present as an early or a late complication after TEVAR due to stent-grafting-related issues or disease progression. Open operation can be performed to treat TAAD, and this has acceptable early and mid-term outcomes. Follow-up should become mandatory for patients after TEVAR because these patients are at increased risk for TAAD.

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Title: Surgical Treatment for Type A Aortic Dissection after Endovascular Aortic Repair: A 12-year, Single-Center Study
Authors: Yuan Xue
Shipan Wang
Xuehuan Zhang
Xiaomeng Wang
Yue Shi
Hongjia Zhang
Duanduan Chen
Haiyang Li
Publication date: 15-03-2024
Publisher: Springer US
Keyword: Aortic Dissection
Published in: Cardiovascular Drugs and Therapy
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI: https://doi.org/10.1007/s10557-024-07565-1

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Springer Medicine

Surgical Treatment for Type A Aortic Dissection after Endovascular Aortic Repair: A 12-year, Single-Center Study

Abstract

Objective

Methods

Results

Conclusions

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Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page