title: One-stage hybrid repair to thoracoabdominal aortic aneurysm.
abstract: BACKGROUND
  Open repair of a thoracoabdominal aortic aneurysm (TAAA) is associated with high rates of morbidity and mortality. This study reviewed the midterm outcomes of hybrid TAAA repair in high-risk patients at our institution.
  
  
  METHODS
  The clinical data of patients undergoing 1-stage hybrid repair of a TAAA between June 2007 and June 2011 were retrospectively analyzed. This study represents our experience with 10 patients at a single center who underwent 1-stage visceral hybrid procedures for complex thoracoabdominal aortic pathologies. There were 9 men and 1 woman with a median age of 65.7 years. The average preoperative European System for Cardiac Operative Risk Evaluation II score was 34.1%.
  
  
  RESULTS
  The technical success rate with completion was 100%. No procedure was abandoned because of any aortic event. The 30-day mortality rate in this study was 10%. Overall major perioperative complication rates were 20%. Major complications included renal impairment requiring permanent support in 1 patient (10%) and paraplegia in 1 patient (10%). At a median follow-up of 20.1 months (range, 0.3-39 months), the overall survival rate was 70%. The primary graft patency rate was 96.8% (32/33). Only 1 renal artery graft was occluded.
  
  
  CONCLUSIONS
  The midterm results in selected high-risk patients with TAAA undergoing 1-stage hybrid repair were encouraging. When open repair is hazardous and branched stent grafting is not an option, hybrid repair is a viable treatment alternative. However, larger study cohorts and longer durations of follow-up are necessary to provide data on the durability of aortic stent grafts and visceral artery reconstruction.
authors.affiliation: Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: I-Hui
authors.initials: IH
authors.lastname: Wu
authors.affiliation: Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Chan
authors.affiliation: Department of Radiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Po-Chin
authors.initials: PC
authors.lastname: Liang
authors.affiliation: Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shu-Chien
authors.initials: SC
authors.lastname: Huang
authors.affiliation: Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Nai-Shin
authors.initials: NS
authors.lastname: Chi
authors.affiliation: Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: ihuiaaronwu@gmail.com.
authors.forename: Shoei-Shen
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency