Autor(es):
Rodrigues, H ; Castro, JM ; Valentim, H ; Laranjeira, A ; Ferreira, E ; Albuquerque e Castro, J ; Fragata, J ; Mota Capitão, L
Data: 2012
Identificador Persistente: http://hdl.handle.net/10400.17/1478
Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
Assunto(s): HSM CCT; HSM CIR VASC; Falso Aneurisma/patologia; Falso Aneurisma/cirurgia; Aorta Torácica/patologia; Aorta Torácica/cirurgia; Aneurisma da Aorta Torácica/patologia; Aneurisma da Aorta Torácica/cirurgia; Endoleak/patologia; Endoleak/cirurgia; Procedimentos Endovasculares/métodos; Estudos de Follow-Up; Estudos Retrospectivos; Stents; Resultado de Tratamento
Descrição
Objectives: To retrospectively review the hybrid treatment of the aortic arch with supra-aortic debranching and endo- vascular stent-graft repair in a single institution. Methods: From 2007 to 2010, all patients submitted to aortic debranching procedures were entered into a prospective database analysis. For the present study, only patients with sealing zones 0 and 1, according to the Ishimaru classification, were included. Procedure-related morbimortality was analysed for the open and endovascular procedures. Results: During the study period, we electively performed 6 total aortic debranching and 4 partial aortic debranching procedures in 10 patients. According to the etiology the indications were: 6 aortic arch aneurysms, 2 post-dissection aneu- rysms, 1 false aneurysm and 1 type I endoleak following TEVAR. The proximal sealing zone was Ishimaru zone 0 in six patients and zone 1 in four patients. The TEVAR procedure was delayed in all patients with a completion success of 80% (1 patient died from ruptured aortic aneurysm; 1 patient denied the second procedure and was lost to follow-up). The 30d mortality rate was 10% (patient mentioned above). The main morbidity was: 1 axillar venous thrombosis, 1 case of subclinical myocardial infarction, 1 case of terminal renal insufficiency and 1 case of prolonged ventilation. No permanent cerebral or peripheral neurologic deficit was noted. Conclusions: The hybrid repair of the aortic arch is a feasible and reproducible procedure, and our results are similar to the previously published series. Medium and long-term results are necessary to confirm whether the technique can be regarded as a safe alternative to open surgery in high-risk patients.
