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SHR Neuro Cancer Cardio Lipid Metab Microb

Czerny, M; Funovics, M; Sodeck, G; Dumfarth, J; Schoder, M; Juraszek, A; Dziodzio, T; Zimpfer, D; Loewe, C; Lammer, J; Rosenhek, R; Ehrlich, M; Grimm, M.
Long-term results of thoracic endovascular aortic repair in atherosclerotic aneurysms involving the descending aorta.
J Thorac Cardiovasc Surg. 2010; 140(6 Suppl):S179-84; discussion S185-S190 Doi: 10.1016/j.jtcvs.2010.06.031
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Zimpfer Daniel
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Abstract:
OBJECTIVE: This study evaluated long-term results of thoracic endovascular aortic repair for atherosclerotic aneurysms involving descending aorta. METHODS: One hundred thirteen patients underwent thoracic endovascular aortic repair for this indication from 1996 to 2009. Mean follow-up was 54 ± 38 months (5-144 months). In-hospital mortality, neurologic injury, need for rerouting, occurrence of endoleaks and their treatment, and survival were recorded. RESULTS: In-hospital mortality was 5.3%. Transient neurologic injury rate was 2.6%. Previous rerouting was performed in 51%. Assisted early and late type I and III endoleak rates were 7.9% and 5.7%, respectively. Five percent of patients required late surgical conversion. Actuarial survivals were 86%, 60%, and 42% at 1, 5, and 10 years, respectively. Aorta-related actuarial survivals were 94%, 90%, and 83% at 1, 5, and 10 years, respectively. Cox regression analysis revealed higher number of prostheses as independent risk factor for early (hazard ratio, 5.38; 95% confidence interval, 1.68-42.37) and late (hazard ratio, 8.49; 95% confidence interval, 1.09-66.06) endoleak formation. Female sex (hazard ratio, 0.35; 95% confidence interval, 0.13-0.99), no arch involvement (hazard ratio, 0.21; 95% confidence interval, 0.05-0.08), and higher number of prostheses (hazard ratio, 7.95; 95% confidence interval, 1.36-46.58) affected survival. CONCLUSIONS: Aorta-related survival is excellent among patients undergoing thoracic endovascular aortic repair for atherosclerotic aneurysms involving the descending aorta. Life-long surveillance remains mandatory, with early and late failure uncommon but still needing consideration. Thoracic endovascular aortic repair in this group of patients remains attractive and has now proven durability.
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