Aortic remodeling after hybrid provisional extension to induce complete attachment aortic repair of chronic residual type I aortic dissection

Chun Yang Huang, Hung Lung Hsu, Po Lin Chen, Tzu Ting Kuo, I. Ming Chen, Chiao Po Hsu, Chun Che Shih

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: Our objective was to examine the role of the provisional extension to induce complete attachment (PETTICOAT) aortic dissection repair technique with bare metal stents (BMSs) in abdominal remodeling of residual DeBakey type I aortic dissection. Methods: We retrospectively reviewed the records of patients with chronic aneurysm formation and residual DeBakey type I aortic dissection (ie, original acute aortic dissection DeBakey type I after primary surgical open repair) who underwent arch reoperation with frozen elephant trunk replacement or endovascular debranching with or without an abdominal BMS between December 2006 and December 2016. We analyzed diameters and volumes in 3 dimensions for the true and false lumens of the thoracic and abdominal aorta as well as the thrombosis percentage of the false lumen between the non-BMS (non-PETTICOAT) and BMS (PETTICOAT) groups. Results: Forty-seven patients who had completed at least 1 year of follow-up were included. The non-BMS (without abdominal BMS) and BMS groups had significant differences in abdominal true lumen diameter and volumetric change at the first postoperative examination and at the examination 1 year after surgery (26.8 mL, median [19.4-34.1 mL, interquartile range (IQR)]) in non-BMS vs 42.5 mL, median [31.1-57.9 mL, IQR]) in BMS (postoperative survey [F test, 33.775; P = .000]) and (30.1 mL, median [20.5-34.1 mL, IQR] in non-BMS vs 46.6 mL, median [31.3-57.4 mL, IQR]) in BMS (12-month survey [F test, 14.001; P = .001]). The abdominal false lumen thrombosis percentage was higher in the BMS group than in the non-BMS group (25.6%, median [16.4%-58.9%, IQR] in non-BMS vs 54.0%, median [36.7%-65.3%, IQR] in the BMS group (F test, 6.318; P = .016). Conclusions: Following reintervention for chronic residual DeBakey type I aortic dissection, PETTICOAT abdominal dissection BMS effectively expanded the thoracic and abdominal true lumen and augmented false lumen thrombosis percentage during the first postoperative year.

Original languageEnglish
Pages (from-to)1007-1016
Number of pages10
JournalJournal of Thoracic and Cardiovascular Surgery
Volume158
Issue number4
DOIs
Publication statusPublished - Oct 1 2019
Externally publishedYes

Fingerprint

Stents
Dissection
Metals
Thrombosis
Abdominal Aorta
Thoracic Aorta
Reoperation
Aneurysm
Thorax

Keywords

  • aortic dissection
  • aortic remodeling
  • bare metal stent
  • PETTICOAT
  • residual aortic dissection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Aortic remodeling after hybrid provisional extension to induce complete attachment aortic repair of chronic residual type I aortic dissection. / Huang, Chun Yang; Hsu, Hung Lung; Chen, Po Lin; Kuo, Tzu Ting; Chen, I. Ming; Hsu, Chiao Po; Shih, Chun Che.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 158, No. 4, 01.10.2019, p. 1007-1016.

Research output: Contribution to journalArticle

Huang, Chun Yang ; Hsu, Hung Lung ; Chen, Po Lin ; Kuo, Tzu Ting ; Chen, I. Ming ; Hsu, Chiao Po ; Shih, Chun Che. / Aortic remodeling after hybrid provisional extension to induce complete attachment aortic repair of chronic residual type I aortic dissection. In: Journal of Thoracic and Cardiovascular Surgery. 2019 ; Vol. 158, No. 4. pp. 1007-1016.
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abstract = "Objectives: Our objective was to examine the role of the provisional extension to induce complete attachment (PETTICOAT) aortic dissection repair technique with bare metal stents (BMSs) in abdominal remodeling of residual DeBakey type I aortic dissection. Methods: We retrospectively reviewed the records of patients with chronic aneurysm formation and residual DeBakey type I aortic dissection (ie, original acute aortic dissection DeBakey type I after primary surgical open repair) who underwent arch reoperation with frozen elephant trunk replacement or endovascular debranching with or without an abdominal BMS between December 2006 and December 2016. We analyzed diameters and volumes in 3 dimensions for the true and false lumens of the thoracic and abdominal aorta as well as the thrombosis percentage of the false lumen between the non-BMS (non-PETTICOAT) and BMS (PETTICOAT) groups. Results: Forty-seven patients who had completed at least 1 year of follow-up were included. The non-BMS (without abdominal BMS) and BMS groups had significant differences in abdominal true lumen diameter and volumetric change at the first postoperative examination and at the examination 1 year after surgery (26.8 mL, median [19.4-34.1 mL, interquartile range (IQR)]) in non-BMS vs 42.5 mL, median [31.1-57.9 mL, IQR]) in BMS (postoperative survey [F test, 33.775; P = .000]) and (30.1 mL, median [20.5-34.1 mL, IQR] in non-BMS vs 46.6 mL, median [31.3-57.4 mL, IQR]) in BMS (12-month survey [F test, 14.001; P = .001]). The abdominal false lumen thrombosis percentage was higher in the BMS group than in the non-BMS group (25.6{\%}, median [16.4{\%}-58.9{\%}, IQR] in non-BMS vs 54.0{\%}, median [36.7{\%}-65.3{\%}, IQR] in the BMS group (F test, 6.318; P = .016). Conclusions: Following reintervention for chronic residual DeBakey type I aortic dissection, PETTICOAT abdominal dissection BMS effectively expanded the thoracic and abdominal true lumen and augmented false lumen thrombosis percentage during the first postoperative year.",
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T1 - Aortic remodeling after hybrid provisional extension to induce complete attachment aortic repair of chronic residual type I aortic dissection

AU - Huang, Chun Yang

AU - Hsu, Hung Lung

AU - Chen, Po Lin

AU - Kuo, Tzu Ting

AU - Chen, I. Ming

AU - Hsu, Chiao Po

AU - Shih, Chun Che

N1 - Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Objectives: Our objective was to examine the role of the provisional extension to induce complete attachment (PETTICOAT) aortic dissection repair technique with bare metal stents (BMSs) in abdominal remodeling of residual DeBakey type I aortic dissection. Methods: We retrospectively reviewed the records of patients with chronic aneurysm formation and residual DeBakey type I aortic dissection (ie, original acute aortic dissection DeBakey type I after primary surgical open repair) who underwent arch reoperation with frozen elephant trunk replacement or endovascular debranching with or without an abdominal BMS between December 2006 and December 2016. We analyzed diameters and volumes in 3 dimensions for the true and false lumens of the thoracic and abdominal aorta as well as the thrombosis percentage of the false lumen between the non-BMS (non-PETTICOAT) and BMS (PETTICOAT) groups. Results: Forty-seven patients who had completed at least 1 year of follow-up were included. The non-BMS (without abdominal BMS) and BMS groups had significant differences in abdominal true lumen diameter and volumetric change at the first postoperative examination and at the examination 1 year after surgery (26.8 mL, median [19.4-34.1 mL, interquartile range (IQR)]) in non-BMS vs 42.5 mL, median [31.1-57.9 mL, IQR]) in BMS (postoperative survey [F test, 33.775; P = .000]) and (30.1 mL, median [20.5-34.1 mL, IQR] in non-BMS vs 46.6 mL, median [31.3-57.4 mL, IQR]) in BMS (12-month survey [F test, 14.001; P = .001]). The abdominal false lumen thrombosis percentage was higher in the BMS group than in the non-BMS group (25.6%, median [16.4%-58.9%, IQR] in non-BMS vs 54.0%, median [36.7%-65.3%, IQR] in the BMS group (F test, 6.318; P = .016). Conclusions: Following reintervention for chronic residual DeBakey type I aortic dissection, PETTICOAT abdominal dissection BMS effectively expanded the thoracic and abdominal true lumen and augmented false lumen thrombosis percentage during the first postoperative year.

AB - Objectives: Our objective was to examine the role of the provisional extension to induce complete attachment (PETTICOAT) aortic dissection repair technique with bare metal stents (BMSs) in abdominal remodeling of residual DeBakey type I aortic dissection. Methods: We retrospectively reviewed the records of patients with chronic aneurysm formation and residual DeBakey type I aortic dissection (ie, original acute aortic dissection DeBakey type I after primary surgical open repair) who underwent arch reoperation with frozen elephant trunk replacement or endovascular debranching with or without an abdominal BMS between December 2006 and December 2016. We analyzed diameters and volumes in 3 dimensions for the true and false lumens of the thoracic and abdominal aorta as well as the thrombosis percentage of the false lumen between the non-BMS (non-PETTICOAT) and BMS (PETTICOAT) groups. Results: Forty-seven patients who had completed at least 1 year of follow-up were included. The non-BMS (without abdominal BMS) and BMS groups had significant differences in abdominal true lumen diameter and volumetric change at the first postoperative examination and at the examination 1 year after surgery (26.8 mL, median [19.4-34.1 mL, interquartile range (IQR)]) in non-BMS vs 42.5 mL, median [31.1-57.9 mL, IQR]) in BMS (postoperative survey [F test, 33.775; P = .000]) and (30.1 mL, median [20.5-34.1 mL, IQR] in non-BMS vs 46.6 mL, median [31.3-57.4 mL, IQR]) in BMS (12-month survey [F test, 14.001; P = .001]). The abdominal false lumen thrombosis percentage was higher in the BMS group than in the non-BMS group (25.6%, median [16.4%-58.9%, IQR] in non-BMS vs 54.0%, median [36.7%-65.3%, IQR] in the BMS group (F test, 6.318; P = .016). Conclusions: Following reintervention for chronic residual DeBakey type I aortic dissection, PETTICOAT abdominal dissection BMS effectively expanded the thoracic and abdominal true lumen and augmented false lumen thrombosis percentage during the first postoperative year.

KW - aortic dissection

KW - aortic remodeling

KW - bare metal stent

KW - PETTICOAT

KW - residual aortic dissection

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