Cited 150 times in
Total arch repair versus hemiarch repair in the management of acute DeBakey type I aortic dissection
DC Field | Value | Language |
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dc.contributor.author | 이택연 | - |
dc.date.accessioned | 2014-12-20T17:41:06Z | - |
dc.date.available | 2014-12-20T17:41:06Z | - |
dc.date.issued | 2011 | - |
dc.identifier.issn | 1010-7940 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/95067 | - |
dc.description.abstract | OBJECTIVE: In acute DeBakey type I aortic dissection, it is still controversial whether to perform extended aortic replacement to improve long-term outcome or to use a conservative strategy with ascending aortic and hemiarch replacement to palliate a life-threatening condition. METHODS: Between 1999 and 2009, 188 consecutive patients (93 women; mean age, 57.4±11.7 years) with acute DeBakey type I aortic dissection underwent hemiarch (Hemiarch group; n=144) or total arch replacement (Total arch group; n=44) in conjunction with ascending aorta replacement. Clinical outcomes were compared after adjustment for baseline characteristics using inverse-probability-of-treatment weighting. RESULTS: Median follow-up was 47.5 months (range 0-130.4 months) and was 92.0% (n=173) complete. Five-year unadjusted survival and permanent-neurologic-injury-free survival rates were 65.8±8.3% and 43.1±9.7% in the Total arch group, and 83.2±3.3% and 75.2±4.0% in the Hemiarch group, respectively (P=0.013 and <0.001). After adjustment, the Total arch group patients were at greater risks of death (hazard ratio (HR) 2.38, 95% confidence interval (CI) 1.21-4.67; P=0.012), and permanent neurologic injury (HR 3.25, 95% CI 1.31-8.04; P=0.011) compared to the Hemiarch group patients. The risks of the re-operation for aortic pathology or distal aortic dilatation (>55 mm) were similar for both groups (HR 0.33, 95% CI 0.08-1.43; P=0.14). CONCLUSIONS: Total arch repair was associated with greater morbidity and mortality compared with hemiarch repair in acute DeBakey type I aortic dissection. Rates of aortic re-operation or aortic dilatation were not significantly different between the two surgical strategies. These findings support a conservative surgical approach to circumvent this life-threatening situation. | - |
dc.description.statementOfResponsibility | open | - |
dc.format.extent | 881~887 | - |
dc.relation.isPartOf | EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Acute Disease | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Aneurysm, Dissecting/surgery* | - |
dc.subject.MESH | Aorta/surgery | - |
dc.subject.MESH | Aorta, Thoracic/surgery* | - |
dc.subject.MESH | Aortic Aneurysm, Thoracic/surgery* | - |
dc.subject.MESH | Blood Vessel Prosthesis | - |
dc.subject.MESH | Blood Vessel Prosthesis Implantation/adverse effects | - |
dc.subject.MESH | Blood Vessel Prosthesis Implantation/methods* | - |
dc.subject.MESH | Epidemiologic Methods | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Reoperation | - |
dc.subject.MESH | Treatment Outcome | - |
dc.title | Total arch repair versus hemiarch repair in the management of acute DeBakey type I aortic dissection | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Thoracic & Cardiovascular Surgery (흉부외과학) | - |
dc.contributor.googleauthor | Joon Bum Kim | - |
dc.contributor.googleauthor | Cheol Hyun Chung | - |
dc.contributor.googleauthor | Duk Hwan Moon | - |
dc.contributor.googleauthor | Geong Jun Ha | - |
dc.contributor.googleauthor | Taek Yeon Lee | - |
dc.contributor.googleauthor | Sung Ho Jung | - |
dc.contributor.googleauthor | Suk Jung Choo | - |
dc.contributor.googleauthor | Jae Won Lee | - |
dc.identifier.doi | 10.1016/j.ejcts.2010.12.035 | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A03267 | - |
dc.relation.journalcode | J00811 | - |
dc.identifier.eissn | 1873-734X | - |
dc.identifier.pmid | 21315615 | - |
dc.identifier.url | http://ejcts.oxfordjournals.org/content/40/4/881.short | - |
dc.subject.keyword | Aorta | - |
dc.subject.keyword | Surgery | - |
dc.subject.keyword | Mortality | - |
dc.subject.keyword | Morbidity | - |
dc.contributor.alternativeName | Lee, Taek Yeon | - |
dc.contributor.affiliatedAuthor | Lee, Taek Yeon | - |
dc.rights.accessRights | not free | - |
dc.citation.volume | 40 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 881 | - |
dc.citation.endPage | 887 | - |
dc.identifier.bibliographicCitation | EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol.40(4) : 881-887, 2011 | - |
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