Boston - American Association for Thoracic Surgery

More documents

Recommendations

Info

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTS11. Effect of Partial Thrombosis on Distal Aorta After Repair of AcuteDeBakey Type I Aortic DissectionSuk-Won Song, 1 Byung-Chul Chang, 2*† Bum-Koo Cho, 2*∞ Kyung-Jong Yoo 21. Yondong Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;2. Severance Hospital, Yonsei University College of Medicine, Seoul, South KoreaInvited Discussant: Anthony L. EstreraOBJECTIVE: Patency or thrombosis of the residual aorta after repair of acuteDeBakey type I aortic dissection has been found to predict long-term outcome.However, prognostic implications of partial thrombosis of the residual aorta havenot yet been elucidated. We sought to analyze the impact of partial thrombosis onsegmental growth rates, distal reprocedures, and long-term survival.METHODS: One hundred eighteen consecutive patients (55% male; mean age, 60years) with acute DeBakey type I aortic dissection underwent aggressive resectionof the intimal tear and open distal anastomosis (1997–2007). Hospital mortalitywas 17.8%. Survivors had serial computed tomographic scans: digitization yieldeddistal segmental dimensions.Segment-specific average rates of enlargement and factors influencing fastergrowth were analyzed. Distal reprocedures and patient survival were examined.RESULTS: Sixty-six (61%) patients had imaging data sufficient for growth ratecalculations. The median diameters after repair were as follows: aortic arch, 3.5 cm;descending aorta, 3.6 cm; and abdominal aorta, 2.4 cm. Subsequent growth rateswere 0.34, 0.51, and 0.35 mm/y, respectively. Partial thrombosis of the residual aortapredicted greater growth in the distal aorta (p = 0.005). There were 13 distal aorticreprocedures (8 stent graft insertions, 5 reoperations) for 10 years, and reprocedures-freesurvival was 66%. Partial thrombosis (p = 0.002), or complete patency(p = 0.008) predicted greater risk of aorta-related reprocedures. Cox proportionalhazard analysis revealed eGFR lesser than 60 ml/min/1.73 m2 (p = 0.030), reintubation(p = 0.002), and partial thrombosis (p = 0.023) were independent predictors forpoor long-term outcome.* AATS Member† Graham Memorial Traveling Fellowship 1987–1988∞Graham Memorial Traveling Fellowship 1976–197788
AMERICAN ASSOCIATION FOR THORACIC SURGERYCONCLUSION: Partial thrombosis of the false lumen after repair of acuteDeBakey type I aortic dissection, as compared with complete patent or thrombosis,is a significant independent predictor of aortic enlargement, aorta-related reprocedures,and poor long-term outcome. Survivors who had partial thrombosis afterrepair of aortic dissection require meticulous and frequent follow-up due to a highrisk of deterioration after discharge.MONDAYAfternoon89
Page 1 and 2:
American Associationfor Thoracic Su
Page 3 and 4:
AMERICAN ASSOCIATION FOR THORACIC S
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40: AMERICAN ASSOCIATION FOR THORACIC S
Page 89: AMERICAN ASSOCIATION FOR THORACIC S
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 227 and 228:
AATS FUTURE MEETINGSMay 1-5, 2010Me
show all

Boston - American Association for Thoracic Surgery

Create successful ePaper yourself

Delete template?

Save as template?