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KMID : 0364020140470030255
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Korean Journal of Thoracic and Cardiovascular Surgery
2014 Volume.47 No. 3 p.255 ~ p.261
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Outcomes of Open Surgical Repair of Descending Thoracic Aortic Disease
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Lee Won-Young
Yoo Jae-Suk
Kim Joon-Bum
Jung Sung-Ho
Choo Suk-Jung
Chung Cheol-Hyun
Lee Jae-Won
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Abstract
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Background: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair.
Methods: We identified 103 patients (23 females; mean age, 64.1±12.3 years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%).
Results: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was 80.9%±4.3% and 71.7%±5.9%, respectively. Reoperation-free survival at 5 and 10 years was 77.3%±4.8% and 70.2%±5.8%. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p＜0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p＜0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49).
Conclusion: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.
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KEYWORD
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Aorta, Descending thoracic aorta, Cardiopulmonary bypass
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