Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology
BackgroundThe hybrid arch repair (HAR) is an appealing surgical option in the management of aortic arch diseases. The aim is to evaluate the short and mid-term outcomes of type II HAR involving replacement of the ascending aorta, arch debranching, and zone 0 stent graft deployment in diverse arch pa...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.882783/full |
| _version_ | 1828331755432574976 |
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| author | Yanxiang Liu Bowen Zhang Shenghua Liang Yaojun Dun Hongwei Guo Xiangyang Qian Cuntao Yu Xiaogang Sun |
| author_facet | Yanxiang Liu Bowen Zhang Shenghua Liang Yaojun Dun Hongwei Guo Xiangyang Qian Cuntao Yu Xiaogang Sun |
| author_sort | Yanxiang Liu |
| collection | DOAJ |
| description | BackgroundThe hybrid arch repair (HAR) is an appealing surgical option in the management of aortic arch diseases. The aim is to evaluate the short and mid-term outcomes of type II HAR involving replacement of the ascending aorta, arch debranching, and zone 0 stent graft deployment in diverse arch pathologies.Methods200 patients with various diffuse aortic pathologies involving the arch were enrolled between 2016 and 2019. Complex arch diseases included acute type A dissection (n = 129, 64.5%), acute type B dissection (n = 16, 8.0%), aortic arch aneurysm (n = 42, 21.0%) and penetrating arch ulcer (n = 13, 6.5%). Mortality, morbidity, survival and re-intervention were analyzed.ResultsThe overall 30-day mortality rate was 8.0% (16/200). Stroke was present in 3.5% (7/200) of the general cohort and spinal cord injury was occurred in 3.0% (6/200). Multivariable logistic analysis showed that cardiac malperfusion and CPB time were the risk factors associated with 30-day mortality. The mean follow-up duration was 25.9 months (range 1–57.2 months), and the 3-year survival rate was 83.1%. On Cox regression analysis, age, diabetes, cardiac malperfusion and CPB time predicted short and mid-term overall mortality. A total of 3 patients required reintervention during the follow-up due to the thrombosis of epiaortic artificial vessels (n = 1), anastomotic leak at the site of the proximal ascending aorta (n = 1) and the type I endoleak (n = 1).ConclusionsType II HAR was performed with satisfactory early and mid-term outcomes in complex aortic arch pathologies. |
| first_indexed | 2024-04-13T20:57:22Z |
| format | Article |
| id | doaj.art-d41c2d42b64c4b5b95b2bff48ff0952c |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T20:57:22Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-d41c2d42b64c4b5b95b2bff48ff0952c2022-12-22T02:30:17ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-06-01910.3389/fcvm.2022.882783882783Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch PathologyYanxiang LiuBowen ZhangShenghua LiangYaojun DunHongwei GuoXiangyang QianCuntao YuXiaogang SunBackgroundThe hybrid arch repair (HAR) is an appealing surgical option in the management of aortic arch diseases. The aim is to evaluate the short and mid-term outcomes of type II HAR involving replacement of the ascending aorta, arch debranching, and zone 0 stent graft deployment in diverse arch pathologies.Methods200 patients with various diffuse aortic pathologies involving the arch were enrolled between 2016 and 2019. Complex arch diseases included acute type A dissection (n = 129, 64.5%), acute type B dissection (n = 16, 8.0%), aortic arch aneurysm (n = 42, 21.0%) and penetrating arch ulcer (n = 13, 6.5%). Mortality, morbidity, survival and re-intervention were analyzed.ResultsThe overall 30-day mortality rate was 8.0% (16/200). Stroke was present in 3.5% (7/200) of the general cohort and spinal cord injury was occurred in 3.0% (6/200). Multivariable logistic analysis showed that cardiac malperfusion and CPB time were the risk factors associated with 30-day mortality. The mean follow-up duration was 25.9 months (range 1–57.2 months), and the 3-year survival rate was 83.1%. On Cox regression analysis, age, diabetes, cardiac malperfusion and CPB time predicted short and mid-term overall mortality. A total of 3 patients required reintervention during the follow-up due to the thrombosis of epiaortic artificial vessels (n = 1), anastomotic leak at the site of the proximal ascending aorta (n = 1) and the type I endoleak (n = 1).ConclusionsType II HAR was performed with satisfactory early and mid-term outcomes in complex aortic arch pathologies.https://www.frontiersin.org/articles/10.3389/fcvm.2022.882783/fullhybrid arch repair (HAR)aortic arch pathologyaortic dissection (AD)arch aneurysmdeep hypothermic circulatory arrest |
| spellingShingle | Yanxiang Liu Bowen Zhang Shenghua Liang Yaojun Dun Hongwei Guo Xiangyang Qian Cuntao Yu Xiaogang Sun Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology Frontiers in Cardiovascular Medicine hybrid arch repair (HAR) aortic arch pathology aortic dissection (AD) arch aneurysm deep hypothermic circulatory arrest |
| title | Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology |
| title_full | Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology |
| title_fullStr | Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology |
| title_full_unstemmed | Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology |
| title_short | Early and Midterm Outcomes of Type II Hybrid Arch Repair for Complex Aortic Arch Pathology |
| title_sort | early and midterm outcomes of type ii hybrid arch repair for complex aortic arch pathology |
| topic | hybrid arch repair (HAR) aortic arch pathology aortic dissection (AD) arch aneurysm deep hypothermic circulatory arrest |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.882783/full |
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