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Clinical outcomes of different surgical approaches for proximal descending thoracic aneurysm involving the distal arch  Hyun-Chel Joo, MD, Young-Nam Youn,

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Presentation on theme: "Clinical outcomes of different surgical approaches for proximal descending thoracic aneurysm involving the distal arch  Hyun-Chel Joo, MD, Young-Nam Youn,"— Presentation transcript:

1 Clinical outcomes of different surgical approaches for proximal descending thoracic aneurysm involving the distal arch  Hyun-Chel Joo, MD, Young-Nam Youn, MD, PhD, Seung-Hyun Lee, MD, PhD, Sak Lee, MD, PhD, Byung-Chul Chang, MD, PhD, Kyung-Jong Yoo, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 155, Issue 6, Pages e1 (June 2018) DOI: /j.jtcvs Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Current study cohort of 229 patients who underwent aortic repair for proximal descending aortic aneurysm involving the distal arch. DTA, Descending thoracic aneurysm; TAR, total arch and descending replacement via sternotomy; DTR, hemiarch and descending replacement via thoracotomy; TEVAR, thoracic endovascular aortic repair; HAR, hybrid arch repair; TAAA, thoracoabdominal aortic aneurysm; CABG, coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 The comparison of in-hospital mortality and perioperative stroke rates among the 3 groups. TAR, Total arch and descending replacement via sternotomy; DTR, hemiarch and descending replacement via thoracotomy; HAR, hybrid arch repair. The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Kaplan-Meier curves comparing the overall survival rate of the three groups. TAR, Total arch and descending replacement via sternotomy; DTR, hemiarch and descending replacement via thoracotomy; HAR, hybrid arch repair. The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Kaplan-Meier curves comparing (A) the reintervention-free survival rate and (B) the composite of aortic event (aortic-related death, stroke, reintervention, or surgery)-free survival rate among the 3 groups. TAR, Total arch and descending replacement via sternotomy; DTR, hemiarch and descending replacement via thoracotomy; HAR, hybrid arch repair. The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

6 Figure E1 The change of distribution of 3 surgery types from 2002 to TAR, Total arch and descending thoracic aneurysm (DTA) replacement via sternotomy; DTR, DTA replacement via thoracotomy; HAR, hybrid arch repair. The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

7 Sternotomy approach has better outcomes compared with thoracotomy or hybrid approaches.
The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

8 Video 1 Sternotomy approach for proximal descending aneurysm involving the arch. Total arch and proximal descending aorta replacement was performed using right axillary cannulation, bilateral antegrade cerebral perfusion, mild hyperthermia (28°C), and a 4-branched graft. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , e1DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

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