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  4. Descending thoracic aortic repair outcomes for chronic aortic dissection: a single-centre experience

Descending thoracic aortic repair outcomes for chronic aortic dissection: a single-centre experience

Interact CardioVasc Thorac Surg, 2022 · DOI: 10.1093/icvts/ivac233 · Published: September 14, 2022

Cardiovascular ScienceSurgery

Simple Explanation

This study looks at the outcomes of open surgical repair for chronic aortic dissection specifically focusing on the descending thoracic aorta. The goal was to see how well patients did in the short and long term after this type of surgery. The study found that this surgery can have good results, especially for patients who are considered low-risk. Low-risk patients were defined as those under 70 years old who had the surgery electively. The authors suggest that open surgical repair is still a good option for these low-risk patients, especially when the dissection is limited to the descending thoracic aorta.

Study Duration
January 2012 and December 2020
Participants
492 patients with chronic aortic dissection
Evidence Level
Not specified

Key Findings

  • 1
    Descending thoracic aortic repair for chronic aortic dissection resulted in good early and long-term results.
  • 2
    Age > 70 years and non-elective surgery were independent predictors of early major adverse events.
  • 3
    The 5-year survival rate was 87.2%.

Research Summary

This study evaluated the outcomes of descending thoracic aortic repair (DTAR) for chronic aortic dissection (CAD) at a single center, finding good early and long-term results. The study identified age over 70 and non-elective surgery as predictors of early major adverse events (MAEs). The authors conclude that DTAR can be the gold standard for low-risk patients with CAD.

Practical Implications

Treatment Strategy

Open surgical repair (OSR) remains a viable option, particularly for low-risk patients with chronic aortic dissection limited to the descending thoracic aorta.

Risk Stratification

Age and the elective vs. non-elective nature of the surgery are critical factors in predicting patient outcomes.

Surgical Decision-Making

The extent of aortic involvement (descending thoracic aorta only vs. thoracoabdominal aorta) should be considered when choosing between OSR and TEVAR.

Study Limitations

  • 1
    Retrospective study design.
  • 2
    Single-center experience.
  • 3
    Relatively short median follow-up duration (3.2 years).

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