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Clinical outcomes of different surgical approaches for proximal descending thoracic aneurysm involving the distal arch

DC FieldValueLanguage
dc.contributor.author유경종-
dc.contributor.author윤영남-
dc.contributor.author이삭-
dc.contributor.author이승현-
dc.contributor.author장병철-
dc.contributor.author주현철-
dc.date.accessioned2018-09-28T08:57:50Z-
dc.date.available2018-09-28T08:57:50Z-
dc.date.issued2018-
dc.identifier.issn0022-5223-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/163280-
dc.description.abstractBACKGROUND: The aim of this study was to evaluate clinical outcomes of different approaches to patients with proximal descending thoracic aneurysm (DTA) involving the distal arch. METHODS: From January 2002 to December 2016, 229 consecutive patients with proximal descending aorta aneurysm involving the distal arch underwent surgery using different approaches: total arch and DTA replacement via sternotomy (TAR group; n = 98), hemiarch and DTA replacement via thoracotomy (DTR group; n = 84), or hybrid arch repair (HAR group; n = 47). We retrospectively evaluated the outcomes of the 3 groups with a mean follow-up duration of 60.2 months. RESULTS: The in-hospital mortality rate was 3.1% (3/98) in the TAR group, 11.9% (10/84) in the DTR group, and 4.3% (2/47) in the HAR group (P = .04). The TAR group had a lower incidence of stroke (3.1%, 3/98) compared with the DTR (13.1%, 11/84) and HAR (10.6%, 5/47) groups (P = .03). The overall survival rate at 10 years was 82.8% ± 5.6% for the TAR group, 61.0% ± 8.6% for the DTR group, and 55.9% ± 9.0% for the HAR group (vs DTR [P = .03] and HAR [P < .01]). The freedom from composite of aortic events at 10 years was 75.6% ± 8.1% in the TAR group, 43.6% ± 14.9% in the DTR group, and 31.1% ± 11.5% in the HAR group (P < .01). CONCLUSIONS: The sternotomy approach showed better outcomes in terms of operative mortality, stroke, and long-term survival compared with the thoracotomy or hybrid approaches. This study suggests that the sternotomy approach is the superior option for patients with proximal descending aneurysm involving the distal arch.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherMosby-
dc.relation.isPartOfJournal of Thoracic and Cardiovascular Surgery-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleClinical outcomes of different surgical approaches for proximal descending thoracic aneurysm involving the distal arch-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Thoracic & Cardiovascular Surgery-
dc.contributor.googleauthorHyun-Chel Joo-
dc.contributor.googleauthorYoung-Nam Youn-
dc.contributor.googleauthorSeung-Hyun Lee-
dc.contributor.googleauthorSak Lee-
dc.contributor.googleauthorByung-Chul Chang-
dc.contributor.googleauthorKyung-Jong Yoo-
dc.identifier.doi10.1016/j.jtcvs.2017.12.152-
dc.contributor.localIdA02453-
dc.contributor.localIdA02576-
dc.contributor.localIdA02807-
dc.contributor.localIdA02935-
dc.contributor.localIdA03430-
dc.contributor.localIdA03960-
dc.relation.journalcodeJ01906-
dc.identifier.eissn1097-685X-
dc.identifier.pmid29550070-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0022522318304045-
dc.subject.keywordaneurysm-
dc.subject.keyworddifferent approaches-
dc.subject.keyworddistal arch-
dc.subject.keywordproximal descending-
dc.contributor.alternativeNameYoo, Kyung Jong-
dc.contributor.alternativeNameYoun, Young Nam-
dc.contributor.alternativeNameLee, Sak-
dc.contributor.alternativeNameLee, Seung Hyun-
dc.contributor.alternativeNameChang, Byung Chul-
dc.contributor.alternativeNameJoo, Hyun Chel-
dc.contributor.affiliatedAuthorYoo, Kyung Jong-
dc.contributor.affiliatedAuthorYoun, Young Nam-
dc.contributor.affiliatedAuthorLee, Sak-
dc.contributor.affiliatedAuthorLee, Seung Hyun-
dc.contributor.affiliatedAuthorChang, Byung Chul-
dc.contributor.affiliatedAuthorJoo, Hyun Chel-
dc.citation.volume155-
dc.citation.number6-
dc.citation.startPage2289-
dc.citation.endPage2298-
dc.identifier.bibliographicCitationJournal of Thoracic and Cardiovascular Surgery, Vol.155(6) : 2289-2298, 2018-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers

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