076 * Endovascular Therapy in Patients With Genetically Triggered Thoracic Aortic Disease: Applications and Short- and Mid-term Outcomes
Year: 2013
Type: conference-abstract
Abstract: Objectives: For patients with genetically triggered thoracic aortic disease, the morbidity and mortality associated with reoperation are high, making endovascular treatment an appealing option. We evaluated the short- and mid-term outcomes of different applications of endovascular intervention in such patients. Methods: Between January 2003 and February 2013, 58 patients were treated. Inclusion criteria included thoracic aneurysm or dissection not due to trauma in a patient aged 50 years or less (n = 27), bicuspid aortic valve and coarctation (n = 11), Marfan syndrome (n = 10), bicuspid aortic valve with thoracic aneurysm (n = 4), Loeys-Dietz syndrome (n = 3), and familial thoracic aneurysm or dissection (n = 3). Forty patients (68.7%) were treated with only endovascular stent grafting. Eighteen patients (31.0%) underwent a hybrid procedure with open proximal or total arch replacement and concomitant endovascular stenting of the aortic arch or the descending thoracic aorta. Twenty-eight (48.7%) had a median of two cardiovascular operations before undergoing hybrid or endovascular therapy. The median follow-up was 2.2 (range 1.2-4.4) years. Results: The technical success rate was 100%. In-hospital mortality was 3.5% (n = 2), and neurologic events occurred in two patients; one (1.7%) had a stroke, and one (1.7%) suffered paraparesis. Fifteen repeat open or endovascular interventions were required in 11 patients (19.3%). Overall survival during follow-up was 93.1% (n = 54). Conclusions: Endovascular technology can be helpful in treating selected young patients with genetically triggered thoracic aortic disease. Long-term studies and further evolution of endovascular technology will be necessary for it to be incorporated into the armamentarium of surgical options for this challenging patient population.
Authors: O. Preventza, S. Mohammed, B. Y. Cheong, L. Gonzalez, M. Ouzounian, J. J. Livesay, D. A. Cooley, J. S. Coselli
Institutions: Baylor St. Luke's Medical Center, Baylor College of Medicine
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2329810752