Reparação Híbrida do Arco Aórtico: Experiência Inicial do Hospital de Santa Marta

• Autor(a) principal: Rodrigues, H
• Data de Publicação: 2012
• Outros Autores: Castro, JM, Valentim, H, Laranjeira, A, Ferreira, E, Albuquerque e Castro, J, Fragata, J, Mota Capitão, L
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/1478
• topic: HSM CCT; HSM CIR VASC; Falso Aneurisma/patologia; Falso Aneurisma/cirurgia; Aorta Torácica/patologia; Aorta Torácica/cirurgia; Aneurisma da Aorta Torácica/patologia; Aneurisma da Aorta Torácica/cirurgia; Endoleak/patologia; Endoleak/cirurgia; Procedimentos Endovasculares/métodos; Estudos de Follow-Up; Estudos Retrospectivos; Stents; Resultado de Tratamento

Objectives: To retrospectively review the hybrid treatment of the aortic arch with supra-aortic debranching and endo- vascular stent-graft repair in a single institution. Methods: From 2007 to 2010, all patients submitted to aortic debranching procedures were entered into a prospective database analysis. For the present study, only patients with sealing zones 0 and 1, according to the Ishimaru classification, were included. Procedure-related morbimortality was analysed for the open and endovascular procedures. Results: During the study period, we electively performed 6 total aortic debranching and 4 partial aortic debranching procedures in 10 patients. According to the etiology the indications were: 6 aortic arch aneurysms, 2 post-dissection aneu- rysms, 1 false aneurysm and 1 type I endoleak following TEVAR. The proximal sealing zone was Ishimaru zone 0 in six patients and zone 1 in four patients. The TEVAR procedure was delayed in all patients with a completion success of 80% (1 patient died from ruptured aortic aneurysm; 1 patient denied the second procedure and was lost to follow-up). The 30d mortality rate was 10% (patient mentioned above). The main morbidity was: 1 axillar venous thrombosis, 1 case of subclinical myocardial infarction, 1 case of terminal renal insufficiency and 1 case of prolonged ventilation. No permanent cerebral or peripheral neurologic deficit was noted. Conclusions: The hybrid repair of the aortic arch is a feasible and reproducible procedure, and our results are similar to the previously published series. Medium and long-term results are necessary to confirm whether the technique can be regarded as a safe alternative to open surgery in high-risk patients.