Korean J Thorac Cardiovasc Surg.  2016 Apr;49(2):73-79. 10.5090/kjtcs.2016.49.2.73.

Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

• Choi JS
• Oh SJ
• Sung YW
• Moon HJ
• Lee JS

• KMID: 2161800
• DOI: http://doi.org/10.5090/kjtcs.2016.49.2.73

Abstract

BACKGROUND
The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition.
METHODS
Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA.
RESULTS
The mean age was 72.4±5.1 years, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was 269.8±72.3 minutes. The mean total length of aortic coverage was 186.0±49.2 mm. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of 16.8±14.8 months, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown.
CONCLUSION
TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.

Keyword

Aneurysm; Aorta; Rupture; Stents

MeSH Terms

Aneurysm
Aorta
Aortic Aneurysm, Thoracic*
Atrial Fibrillation
Cause of Death
Delirium
Emergencies
Endoleak
Follow-Up Studies
Hemoptysis
Hemothorax
Humans
Male
Mortality
Operative Time
Paraplegia
Rupture
Shock
Stents
Stroke