Background. We present a single center's experience of secondary interventions after thoracic endovascular aortic repair (TEVAR). Methods. One hundred and forty-seven patients underwent TEVAR at our institution between 2000 and 2012. A total of 26 patients (19 male, mean age 68.4 +/- 12.7 years), including 7 patients with primary TEVAR at other centers, underwent secondary interventions. The median interval to secondary intervention was 17.2 months (range, 0.22 to 36.1). The indications for secondary interventions included procedure-related dissection (n = 1), collapse of the endovascular device (n = 1), aortoesophageal fistula (n = 1), residual dissection (n = 3), and endoleaks causing dilation of the sac (n = 17) or aortic rupture (n = 3). Sixteen patients underwent open conversion including total arch replacement (n = 2), extensive replacement of the aortic arch or descending aorta (n = 10), and thoracoabdominal aortic replacement (n = 4). Second-time TEVAR was performed in the remaining 10 patients. Results. The in-hospital mortality rate was 11.5% (3 patients; 1 case of multiorgan failure after open conversion, and 1 case of mesenteric ischemia and 1 case of aortic rupture after second-time TEVAR). Postoperative stroke after second-time TEVAR occurred in 1 patient. The cumulative survival rate of the 26 patients was 80.0% +/- 8.0% at 5 years after secondary intervention. Short proximal neck (p = 0.0036), steep angulation of landing zones (p = 0.033), and nonuse of commercially available devices (p = 0.011) were significantly correlated with incidence of TEVAR failure. Conclusions. Secondary surgical procedures after TEVAR can be performed with low mortality and morbidity, despite the precarious preoperative conditions and complex aortic pathologies of patients. (C) 2013 by The Society of Thoracic Surgeons
机构:
Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
King, Ryan W.
Wooster, Mathew D.
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Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Wooster, Mathew D.
Ruddy, Jean M.
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Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Ruddy, Jean M.
Genovese, Elizabeth A.
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Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Genovese, Elizabeth A.
Anderson, Joseph M.
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Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Anderson, Joseph M.
Brothers, Thomas E.
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Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
Brothers, Thomas E.
Veeraswamy, Ravi K.
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Med Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USAMed Univ South Carolina, Div Vasc Surg, 30 Courtenay Dr,MSC 295, Charleston, SC 29425 USA
机构:
Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Xu, Shang Dong
Huang, Fang Jiong
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Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Huang, Fang Jiong
Yang, Jin Fei
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Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Yang, Jin Fei
Li, Zhi Zhong
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Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiol, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Li, Zhi Zhong
Yang, Sheng
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Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Yang, Sheng
Du, Jia Hui
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Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Radiol, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Du, Jia Hui
Zhang, Zhao Guang
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Capital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R ChinaCapital Med Univ, Beijing Anzhen Hosp, Beijing Inst Heart Lung & Vasc Dis, Div Cardiac Surg, Beijing, Peoples R China
Zhang, Zhao Guang
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY,
2010,
139
(06):
: 1548
-
1553
机构:
Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USAUniv Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USA
Mousa, Albeir Y.
Dombrovskiy, Viktor Y.
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Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USAUniv Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USA
Dombrovskiy, Viktor Y.
Haser, Paul B.
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机构:
Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USAUniv Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USA
Haser, Paul B.
Graham, Alan M.
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Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USAUniv Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USA
Graham, Alan M.
Vogel, Todd R.
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Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USAUniv Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Vasc Surg, Surg Outcomes Res Grp, New Brunswick, NJ 08903 USA
机构:
Royal Alexandra Hosp, Dept Surg, Edmonton, AB, CanadaUniv Alberta, Dept Radiol & Diagnost Imaging, Edmonton, AB T6G 2B7, Canada
Winkelaar, Gerrit
Gibney, Noel
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Univ Alberta, Fac Med & Dent, Div Crit Care Med, Edmonton, AB T6G 2B7, CanadaUniv Alberta, Dept Radiol & Diagnost Imaging, Edmonton, AB T6G 2B7, Canada
机构:
Sapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, JapanSapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, Japan
Iba, Yutaka
Nakajima, Tomohiro
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Sapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, JapanSapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, Japan
Nakajima, Tomohiro
Nakazawa, Junji
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Sapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, JapanSapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, Japan
Nakazawa, Junji
Shibata, Tsuyoshi
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Sapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, JapanSapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, Japan
Shibata, Tsuyoshi
Miura, Shuhei
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Sapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, JapanSapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, Japan
Miura, Shuhei
Kawaharada, Nobuyoshi
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Sapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, JapanSapporo Med Univ, Dept Cardiovasc Surg, 291,South 1,West 17,Chuo Ku, Sapporo, Hokkaido 0608543, Japan