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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2007 February;48(1):1-6
Endovascular repair of the descending thoracic aorta: mid-term results and evaluation of magnetic resonance angiography
Farhat F. 1, Attia C. 1, Boussel L. 2, Staat P. 2, Revel D. 2, Douek P. 2, Villard J. 1
1 Department of Cardiovascular Surgery Louis Pradel Hospital, Claude Bernard University INSERM E0226, Bron, France
2 Department of Interventional Radiology CREATIS, CNRS UMR 551, INSERM U 630 Louis Pradel Hospital, Bron, France
Aim. The endoluminal stent-grafting represents an alternative to surgery in the treatment of lesions of the descending thoracic aorta. The purpose of the present study was to evaluate the mid-term results of the Talent™ stent-graft in the different indications of aortic disease and the use of magnetic resonance angiography (MRA) in the diagnosis of complications.
Methods. Over a 3-year period, 23 patients with a high surgical risk and presenting a localized lesion of the descending thoracic aorta had an implantation of a Talent™ stent-graft. Indications were degenerative aneurysm (n=13), false aneurysm (n=7) and penetrating atherosclerotic ulcer (n=3). The feasibility of the endovascular treatment and sizing of the aorta and stent-grafts were determined pre-operatively by MRA and intraoperative angiography. Immediate and mid-term technical and clinical success were assessed by clinical and MRA follow-up.
Results. Endovascular treatment was completed successfully in all patients with no conversion to open repair. There was no intraoperative mortality. The mean operative time was 38±7 min. Primary success rate was 100%. We didn’t have perioperative mortality. The mean follow-up period was 15±5 months. The survival rate was 97% (n=22). Regression of the aneurysmal size was observed in 70% (n=16). MRA diagnosed 3 over 4 postoperative endoleaks that were not diagnosed with the CT-scan, and did not interfere with the nitinol structure of the stent-graft.
Conclusion. Endovascular treatment of the various localized diseases of the descending thoracic aorta is a promising, feasible, alternative technique to open surgery in well selected patients. MRA is well adapted to diagnose postoperative endoleaks.