International Society For Minimally Invasive Cardiothoracic Surgery

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Mid-term Results Of The Seal Thoracic Stent Graft In Aortopathy
Jun Woo Cho, Jae Soek Jang, Oh Choon Kwon.
Catholic University of Daegu, School of Medicine, Daegu, Korea, Republic of.

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past two decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft.Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications, including cardiovascular accidents (CVAs), spinal cord injury, renal failure, requirement for postoperative extracorporeal membrane oxygenation (ECMO) support, and pneumonia. We also investigated the mid-term survival rate and incidence of aorta-related complications.Results: During the study period, 72 patients underwent stent grafting. Among them, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was 37.8630.73 months (range, 0-124 months). Five patients (6.9%) died within 30 days; 3 of them had undergone emergency surgery for aortic rupture. Two patients developed CVAs, one of whom had undergone a hybrid procedure. Spinal cord injuries occurred in 2 patients, but 1 recovered completely during the hospitalization period. Postoperative renal failure, requirement for postoperative ECMO support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%): endoleak in 4 and stent graft-induced new entry in 1. The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively.Conclusions: The use of the Seal thoracic stent graft resulted in good mid-term results. Although long-term follow-up was difficult owing to the low survival in these high-risk patients, the incidence of stent-related aortic complications was low. Further studies will be needed to examine the long-term outcomes of this device.
Figure LEGENDS : Kaplan-Meier curve for freedom from stent-induced aortic events. a) All patients, including those that had undergone hybrid procedures. b)Patients that had undergone thoracic endovascular aortic repair only.


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