Thoracic endovascular aortic repair: impact of urgency on outcome and quality of life

Dick, Florian; Hinder, Dominik; Immer, Franz F; Savolainen, Hannu; Do, Dai Do; Carrel, Thierry P; Schmidli, Jürg (2009). Thoracic endovascular aortic repair: impact of urgency on outcome and quality of life. European journal of cardio-thoracic surgery, 35(1), pp. 96-103. Oxford: Elsevier Science B.V. 10.1016/j.ejcts.2008.08.019

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OBJECTIVES: Endovascular repair of the descending thoracic aorta is a very promising technique in elective and, particularly, emergency situations. This study assessed the impact of urgency of the procedure on outcome and mid-term quality of life in surviving patients. METHODS: Post hoc analysis of prospectively collected data of 58 consecutive patients (January 2001-December 2005) with surgical pathologies of the descending thoracic aorta treated by endovascular means. Six patients were excluded due to recent operations on the ascending aorta before thoracic endovascular repair. The remaining patients (n=52) were 69+/-10 years old, and 43 were men (83%). Twenty-seven had been treated electively, and 25 for emergency indications. Reasons for emergency were acute type B aortic dissections with or without malperfusion syndrome in 14, and aortic ruptures in 11 cases. Follow-up was 29+/-16 months. Endpoints were perioperative and late morbidity and mortality rates and long-term quality of life as assessed by the short form health survey (SF-36) and Hospital Anxiety and Depression Scale questionnaires. RESULTS: Cohorts were comparable regarding age, sex, cardiovascular risk factors, and comorbidities. Perioperative mortality was somewhat higher in emergency cases (12% vs 4%, p=0.34). Paraplegia occurred in one patient in each cohort (4%). Overall quality of life after two and a half years was similar in both treatment cohorts: 72 (58-124) after emergency, and 85 (61-105) after elective endovascular aortic repair (p=0.98). Normal scores range from 85 to 115. Anxiety and depression scores were in the normal range and comparable. CONCLUSIONS: Thoracic endovascular aortic repair is an excellent and safe treatment option for the diseased descending aorta, particularly in emergency situations. Early morbidity and mortality rates can be kept very low. Mid-term quality of life was not affected by the urgency of the procedure. Similarly, mid-term anxiety and depression scores were not increased after emergency situations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Dick, Florian; Immer, Franz F.; Savolainen, Hannu Olavi; Do, Dai-Do; Carrel, Thierry and Schmidli, Jürg

ISSN:

1010-7940

ISBN:

18829340

Publisher:

Elsevier Science B.V.

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:05

Last Modified:

25 Oct 2019 09:16

Publisher DOI:

10.1016/j.ejcts.2008.08.019

PubMed ID:

18829340

Web of Science ID:

000263208600018

BORIS DOI:

10.7892/boris.28276

URI:

https://boris.unibe.ch/id/eprint/28276 (FactScience: 119524)

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