Midterm outcomes of open surgical repair compared with thoracic endovascular repair for isolated descending thoracic aortic disease.
OBJECTIVE
This study aimed to assess the surgical morbidity and mortality of thoracic endovascular repair (TEVAR) as compared with open surgical repair (OSR) for isolated descending thoracic aortic disease.


METHODS
From January 1, 2006 through May 31, 2010, a total of 68 patients with isolated descending thoracic aortic disease were retrospectively reviewed for the presence of perioperative complication, 30-day mortality, and clinical success. The patients were divided into two groups (group 1, OSR, n = 40 vs. group 2, TEVAR, n = 28) and these groups were compared for major variables and late outcomes.


RESULTS
The mean age was 58 years (group I = 54 vs. group II = 63 years, p = 0.011). Significant perioperative complications occurred in 12 patients: 8 (20%) in group I and 4 (13%) in group II (p = 0.3). There were five 30 day mortalities of which 4 occurred in group I and 1 in group II (p = 0.23). Clinical success (effective aortic remodeling and complete false lumen obliteration or thrombosis) was achieved in 20 patients (71%). Mean Kaplan-Meier survival rate at 1 year was similar for both groups (group 1 = 87% vs. group 2 = 80%, p = 0.65).


CONCLUSIONS
Thoracic endovascular repair for isolated thoracic aortic disease shows comparable results to OSR. However, the potential for endoleak or rupture remains a challenge that needs to be addressed in the future. Therefore, close follow-up study is needed for the evaluation of satisfactory long-term outcomes.
Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University College of Medicine, Daegu 700-712, Korea.
Seung Hyun
SH
Lee
Cheol Hyun
CH
Chung
Sung Ho
SH
Jung
Jae Won
JW
Lee
Ji Hoon
JH
Shin
Ki young
Ky
Ko
Hyun Ki
HK
Yoon
Suk Jung
SJ
Choo
D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D004322:Drainage; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013908:Thoracotomy; D016896:Treatment Outcome