Risk profile and operative outcomes in patients with and without Marfan syndrome undergoing thoracoabdominal aortic aneurysm repair

Lau, Christopher; Soletti, Giovanni; Weinsaft, Jonathan W.; Rahouma, Mohamed; Al Zghari, Talal; Olaria, Roberto Perezgrovas; Harik, Lamia; Yaghmour, Mohammad; Dimagli, Arnaldo; Gaudino, Mario; Girardi, Leonard N.

doi:10.1016/j.jtcvs.2023.03.029

Cited by 6 publications

(2 citation statements)

References 35 publications

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“…At five years, survival was 83% and freedom from repair failure was 98%. Lau et al [69] recently published their results of 684 open TAAA repairs in patients with (N = 90) or without (N = 594) Marfan syndrome [69]. In patients with Marfan syndrome, operative mortality (3.3%), major adverse events (13.3%), SCI (3.3%), and dialysis (3.3%) were not statistically different from patients without connective tissue disorders.…”

Section: Connective Tissue Disordersmentioning

confidence: 99%

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Cochennec,

Couture,

Chiche

2023

JCM

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The optimal surgical treatment for extended thoracoabdominal aortic aneurysms (TAAAs) is still a matter of debate. The historical treatment is open repair (OR), but over the past fifteen years, endovascular strategies have gained widespread acceptance. Although several endovascular techniques have been described for the treatment of TAAAs, fenestrated and branched stent grafts (F/BEVARs) are the most frequently used and best documented. They have become the first-line treatment for both high- and moderate-risk surgical patients in most vascular centers. However, no randomized study comparing OR and F/BEVAR has been published, and decision-making is mainly based on the physician’s preference and/or hospital expertise. The objective of this manuscript is to provide an overview of current comparative data for OR and F/BEVAR.

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Section: Connective Tissue Disordersmentioning

confidence: 99%

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Cochennec,

Couture,

Chiche

2023

JCM

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“…Despite these advancements, open surgery for the descending thoracic and thoracoabdominal aorta provides excellent results in high-volume aortic centers and remains first-line therapy in select patient cohorts. [7][8][9] In-step with these advancements, the medical sphere has had expansive knowledge growth, with genetic and biomechanical research providing necessary, and increasingly complex nuance to the preventative medical management of aortic disease. 10,11 Siloed care pathways deter specialists from referring to specialties with overlapping skills who offer alternative treatment options for consideration.…”

Section: Introductionmentioning

confidence: 99%

The Aortic Team Model for the Management of the Distal Arch, Descending Thoracic and Thoracoabdominal Aorta: Appraisal at 3 Years

McClure,

Rommens,

Herget

et al. 2023

Aorta (Stamford)

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Background This study aimed to assess feasibility, logistical challenges, and clinical outcomes associated with the implementation of an Aortic Team model for the management of distal arch, descending thoracic and thoracoabdominal aortic disease. Methods An Aortic Team care pathway was implemented in November 2019. Working as a unit, two cardiac surgeons, two vascular surgeons, an interventional radiologist, a cardiologist, and an anesthesiologist collectively determined care decisions via multispecialty presence at an Aortic Clinic. Cardiac and vascular surgeons operated in tandem for open procedures. Interventional radiology participated alongside cardiac and vascular for endovascular procedures. Cardiology aided in medical therapies for heritable and degenerative disease, and had a lead role for genetics and high-risk pregnancy referrals. The model spanned three hospitals. Clinical outcomes at 3 years were assessed. Results There were 35 descending thoracic and thoracoabdominal surgeries and 77 thoracic endovascular aortic repairs. Endoarch devices were used in 7 cases (Gore Thoracic Branch Endoprosthesis, 4, Terumo RelayBranch, 3) and an endothoracoabdominal device in 4 cases (Cook Zenith t-branch). The Aortic Clinic acquired 456 patients, with yearly increases (54 patients [year 1], 181 patients [year 2], 221 patients [year 3]). For surgery, mortality was 8.6% (3/35), permanent paralysis 5.7% (2/35), stroke 8.6% (3/35), permanent dialysis 0%, and reinterventions 8.6% (3/35). For endovascular cases, mortality was 3.9% (3/77), permanent paralysis 3.9% (3/77), stroke 5.2% (4/77), permanent dialysis 1.3% (1/77), and reinterventions 16.9% (13/77). Conclusion An Aortic Team model is feasible and ensures all treatment options are considered. Conventional open thoracoabdominal procedures showed acceptable outcomes. Endoarch technology shows early promise.

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Open Thoracoabdominal Aortic Aneurysm Repair

Tanaka,

Safi,

Estrera

2024

The Annals of Thoracic Surgery

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Risk profile and operative outcomes in patients with and without Marfan syndrome undergoing thoracoabdominal aortic aneurysm repair

Cited by 6 publications

References 35 publications

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

The Aortic Team Model for the Management of the Distal Arch, Descending Thoracic and Thoracoabdominal Aorta: Appraisal at 3 Years

Open Thoracoabdominal Aortic Aneurysm Repair

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