title: One-Year Follow-Up After Hybrid Thoracoabdominal Aortic Repair.
abstract: BACKGROUND
  Compared to open thoracoabdominal aortic aneurysm (TAAA) repair, hybrid repair is thought to be less invasive with better perioperative outcomes. Due to the extent of the operation and long recovery period, studying perioperative results may not be sufficient for evaluation of the true treatment effect. The aim of this study is to evaluate 1-year mortality and morbidity in patients with TAAA undergoing hybrid repair.
  
  
  METHODS
  In a retrospective cohort study, all medical records of patients undergoing hybrid repair for TAAA at the Erasmus University Medical Center between January 2007 and January 2015 were studied. Primary outcome measures were 30-day and 1-year mortality. Secondary outcome measures included major in-hospital postoperative complications.
  
  
  RESULTS
  A total of 15 patients were included. All-cause mortality was 33% (5 of the 15) at 30 days and 60% (9 of the 15) at 1 year. Aneurysm-related mortality was 33% (5 of the 15) and 53% (8 of the 15) at 30-day and 1-year follow-up, respectively, with colon ischemia being the most common cause of death. Major complication rate was high: myocardial infarction in 2 (13%) cases, acute kidney failure in 5 (33%) cases, bowel ischemia in 3 (20%) cases, and spinal cord ischemia in 1 (7%) case.
  
  
  CONCLUSIONS
  The presumed less invasive nature of hybrid TAAA repair does not seem to result in lower complication rates. The high mortality rate at 30 days continues to rise dramatically thereafter, suggesting that 1-year mortality is a more useful clinical parameter to use in preoperative decision-making for this kind of repair.
authors.affiliation: 1 Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|2 Department of Vascular surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Rob A
authors.initials: RA
authors.lastname: van de Graaf
authors.affiliation: 1 Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Grüne
authors.affiliation: 1 Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|2 Department of Vascular surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Sanne E
authors.initials: SE
authors.lastname: Hoeks
authors.affiliation: 2 Department of Vascular surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Sander
authors.initials: S
authors.lastname: Ten Raa
authors.affiliation: 1 Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Robert Jan
authors.initials: RJ
authors.lastname: Stolker
authors.affiliation: 2 Department of Vascular surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.|Both authors contributed equally as a senior author to this work.
authors.forename: Hence J M
authors.initials: HJ
authors.lastname: Verhagen
authors.affiliation: 1 Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Both authors contributed equally as a senior author to this work.
authors.forename: Felix
authors.initials: F
authors.lastname: van Lier
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002423:Cause of Death; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009426:Netherlands; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: endovascular; hybrid repair; mortality; thoracoabdominal aortic aneurysm; vascular surgery