- 作者：Marcio F. Maciel Da Rocha ; Salvador Mir ; a ; Domingo Adriani ; Francesca Urgnani ; Vicente A. Riambau ; Jaime Mulet
- 关键词：Thoracic aneurysm ; Endovascular ; Complex aneurysm ; Aortic arch ; Thoracoabdominal ; Hybrid surgery
- 刊名：Revista Española de Cardiología (English Edition)
- 出版年：2009
- 出版时间：August 2009
- 年：2009
- 卷：62
- 期：8
- 页码：896-902
- 全文大小：232 K
Introduction and objectives
To review experience at our center with the use of hybrid techniques for treating complex aneurysms of the thoracic aorta.Methods
The medical records of 41 patients (40 male) with complex aortic aneurysms affecting supra-aortic or visceral vessels who underwent hybrid procedures between 1998 and 2007 were reviewed retrospectively. All patients were in American Society of Anesthesiologists category IV. They were divided in 2 groups: group A comprised 32 patients with aneurysms involving the aortic arch and its branches (2 ascending aorta replacements, 1 arch repair, 13 carotid-carotid bypasses, 12 carotid-subclavian bypasses, and 4 with total arch debranching); and group B comprised 9 patients with thoracoabdominal aneurysms and visceral vessel transpositions (4 partial and 5 total debranching). The mean age in group A was 69.3 (1.3) (range, 62–73) years and in group B, 71.5 (5.0) (range, 68-74) years.
Results
The mean hospital stay was 18 (7.1) days (range, 5-35) and 12 (8.2) days (range, 2-15) in groups A and B, respectively. Overall mortality was 12.2 % (3.4 % and 44.4 % in groups A and B, respectively) and neurological morbidity was 3.4 % and 11.1 % in the 2 groups, respectively.
Conclusions
The results obtained with hybrid treatment of the aortic arch area were comparable with those of conventional surgery. However, thoracoabdominal repair with complete revascularization of the visceral branches was associated with high mortality. Consequently, hybrid treatment is a valid option for high-risk patients who do not require complete revascularization in the visceral area.