Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

  • Choi, Jae-Sung (Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center) ;
  • Oh, Se Jin (Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center) ;
  • Sung, Yong Won (Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center) ;
  • Moon, Hyun Jong (Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center) ;
  • Lee, Jung Sang (Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center)
  • Received : 2015.11.30
  • Accepted : 2016.02.12
  • Published : 2016.04.05
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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 $72.4{\pm}5.1years$, 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 $269.8{\pm}72.3minutes$. The mean total length of aortic coverage was $186.0{\pm}49.2mm$. 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 $16.8{\pm}14.8months$, 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.

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References

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  1. TEVAR for ruptured descending thoracic aortic aneurysm: case report vol.15, pp.4, 2016, https://doi.org/10.1590/1677-5449.006716