Technical aspects of branched graft aortic reconstruction in patients with connective tissue disorders.
Connective tissue disorders (CTDs) predispose patients to dilation of the entire aorta, resulting in the development of extensive aneurysms. Aortic reconstruction in CTD patients can be challenging and demands specific approaches to ensure initial success and lasting stability of aortic repair. Herein, we describe technical approaches to aortic reconstruction in patients with CTDs and briefly report our outcomes on the use of branched grafts for reconstruction in this unique population of patients. We conclude that aortic reconstruction in CTD patients with branched grafts can be performed safely, with a low morbidity and mortality and excellent branch patency. Branched surgical grafts should be used preferentially over the inclusion patch technique during open repair to minimize the late development of patch aneurysms.
Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado Denver, Aurora, Colo.
Natalia O
NO
Glebova
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Hospital, Baltimore, Md.
Caitlin W
CW
Hicks
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Hospital, Baltimore, Md.
Ridwan
R
Alam
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Hospital, Baltimore, Md.
Jennifer
J
Lue
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Hospital, Baltimore, Md.
Brandon W
BW
Propper
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Johns Hopkins Hospital, Baltimore, Md. Electronic address: jhblack@jhmi.edu.
James H
JH
Black
D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D000072226:Computed Tomography Angiography; D003240:Connective Tissue Diseases / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency