J Chest Surg.  2021 Jun;54(3):172-178. 10.5090/jcs.20.150.

Mid-Term Results of Thoracic Endovascular Aortic Repair for Complicated Acute Type B Aortic Dissection at a Single Center

Affiliations
  • 1Departments of Thoracic and Cardiovascular Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
  • 2Departments of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea

Abstract

Background
Complicated acute type B aortic dissection is a life-threatening condition with high morbidity and mortality. The aim of this study was to report a single-center experience with endovascular stent-graft repair of acute type B dissection of the thoracic aorta and to evaluate the mid-term outcomes.
Methods
We reviewed 18 patients treated for complicated acute type B aortic dissection by thoracic endovascular aortic repair (TEVAR) from September 2011 to July 2017. The indications for surgery included rupture, impending rupture, limb ischemia, visceral malperfusion, and paraplegia. The median follow-up was 34.50 months (range, 12–80 months).
Results
The median interval from aortic dissection to TEVAR was 5.50 days (range, 0–32 days). There was no in-hospital mortality. All cases of malperfusion improved except for 1 patient. The morbidities included endoleak in 2 patients (11.1%), stroke in 3 patients (16.7%), pneumonia in 2 patients (11.1%), transient ischemia of the left arm in 1 patient (5.6%), and temporary visceral ischemia in 1 patient (5.6%). Postoperative computed tomography angiography at 1 year showed complete thrombosis of the false lumen in 15 patients (83.3%).
Conclusion
TEVAR of complicated type B aortic dissection with a stent-graft was effective, with a low morbidity and mortality rate.

Keyword

Aortic dissection; Ischemia; Outcomes
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