Distal aortic reintervention after surgery for acute DeBakey type I or II aortic dissection: open versus endovascular repair

摘要: OBJECTIVES: Aortic dissection DeBakey type I and II may require distal reinterventions after initial proximal repair. We evaluated outcomes following open versus endovascular approaches to aortic pathologies surgery for acute dissection. METHODS: One hundred forty-one consecutive patients underwent 152 previous or repair [63 (first quartile, 55; third 72) years old; initially 86% I; 54% hemiarch, 39% isolated ascending, 7% total arch replacement] at two tertiary centres in the USA Europe over last 14 years. Among them, 56 85 required reintervention descending aorta, respectively. The median follow-up was 2.1 0.8; 5.8) (439 patientyears). RESULTS: time between longer group (2.7 6.7) vs 0.6 0.1; 3.5) years, P< 0.01). There one irreversible spinal ischaemia stroke group. Two none re-exploration bleeding. 4 more than 1 (6 8%, P= 1). Descending open-repair experienced higher in-hospital mortality (23 0%, 0.01) lower survival 5 (74 ± 8% 96 3%, 65 9% 92 5%, 0.01, respectively). CONCLUSIONS: Endovascular intervention surgical is associated with better survival, does not raise likelihood of later mid-term follow-up.