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Comparison of hybrid endovascular and open surgical repair for proximal aortic arch diseases.

 Woong Chol Kang  ;  Young-Guk Ko  ;  Eak Kyun Shin  ;  Chul-Hyun Park  ;  Donghoon Choi  ;  Young Nam Youn  ;  Do Yun Lee 
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.203(17) : 975-979, 2016 
Journal Title
Issue Date
Aged ; Aneurysm, Dissecting/surgery* ; Aorta, Thoracic/surgery* ; Aortic Aneurysm, Thoracic/surgery* ; Blood Vessel Prosthesis Implantation/methods* ; Endovascular Procedures/methods* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Reoperation ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Rate/trends ; Time Factors ; Treatment Outcome
Hybrid endovascular repair ; Open surgical repair ; Proximal aortic arch diseases
BACKGROUND: To compare the outcomes of hybrid endovascular and open surgical repair for proximal aortic arch diseases. METHODS: A total of 55 consecutive patients with aortic arch aneurysm or aortic dissection involving any of zone 0 to 1 (39 male, age 63.4 ± 14.3 years) underwent a hybrid endovascular repair (n=35) or open surgical repair (n=20) from 2006 to 2014 were analyzed retrospectively. Perioperative and late outcomes were compared. RESULTS: Baseline characteristics were similar between the two groups, except age and EuroSCORE II, which were higher in the hybrid group. Perioperative mortality or stroke was not significantly different between the two groups, however, tended to be lower in the hybrid repair group than in the open repair group (11.4% vs. 30.0%, p=0.144). Incidences of other morbidities did not differ. During follow-up, over-all survival was similar between the hybrid and the open repair was similar (87.3% vs. 79.7% at 1 year and 83.8% vs. 72.4% at 3 years; p=0.319). However, reintervention-free survival was significantly lower for hybrid repair compared with open repair (83.8% vs. 100% at 1 year and 65.7% vs. 100% at 3 years; p=0.022). CONCLUSIONS: Hybrid repair of proximal aortic disease showed comparable perioperative and late outcomes compared with open surgical repair despite a higher reintervention rate during follow-up. Therefore, hybrid repair may be considered as an acceptable treatment alternative to surgery especially in patients at high surgical risk.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Youn, Young Nam(윤영남)
Lee, Do Yun(이도연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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