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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
Online ISSN 1827-191X
Jakob H. 1, Tsagakis K. 1, Pacini D. 2, Di Bartolomeo R. 2, Mestres C. A. 3, Mohr F. W. 4, Bonser R. S. 5, Cerny S. 6, Oberwalder P. 8, Grabenwoger M. 3
1 Department of Thoracic and Cardiovascular Surgery, West German Heart Center Essen, University Hospital Essen, Essen, Germany;
2 Department of Cardiac Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;
3 Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria;
4 Department of Cardiovascular Surgery, Hospital Clínico, University of Barcelona, Barcelona, Spain;
5 Department of Cardiac Surgery, Leipzig Heart Center, University of Leipzig, Leipzig, Germany;
6 Department of Cardiothoracic Surgery, University Hospital Birmingham, NHS Foundation Trust, Birmingham, UK;
7 Department of Cardiac Surgery, Na Homolce Hospital, Prague, Czech Republic;
8 Department of Cardiac Surgery, University Hospital Graz, Graz, Austria
AIM:After the introduction of the hybrid stent-graft “E-vita-open” by the Essen group in 1/2005 for one stage repair of complex thoracic aortic disease, the International E-vita open Registry was founded in 2008 to study the principles of this treatment algorithm and to control reported favorable single center results on a large patient data set basis up to six years after the first clinical implant.
METHODS: Retrospective data work-up after prospective data acquisition was achieved by institution of the International E-vita open Registry with anonymous registration and calculation at Essen University Hospital. From January 2005 to December 2010, 274 patients (mean age 60; 74% males) with complex aortic disease, 190 with aortic dissection (88 acute (AAD), 102 chronic aortic dissection (CAD), and 84 with complex thoracic aortic aneurysm (TAA) were included in the studied.
RESULTS:Eighty-one out of 274 (30%) patients underwent emergency surgery. Stent-graft deployment and arch replacement (238 total, 36 subtotal) was performed under selective antegrade cerebral perfusion (75 min mean). Cardiopulmonary bypass (CPB) and cardiac arrest times were mean 235 and 134 minutes, respectively. In-hospital mortality was 15% (40/274), 18% for AAD, 13% for CAD, and 14% for TAA. New strokes were observed in 6% (16/274), spinal cord injury in 8% (22/274). The false lumen (FL) was evaluated throughout the first hospital stay and at a median follow up time of 59 months after surgery. From the first follow up CT-examination to the last, thoracic complete FL thrombosis increased from 83% to 93% in AAD, from 72% to 92% in CAD. Full exclusion of the aneurysmal disease was achieved in 77% (61/79) during the primary hospital stay.
CONCLUSION:Favorable single center results could be confirmed by an International community of cardiac surgical centers in regard to hospital mortality and morbidity, as well as a low postoperative complication rate and exclusion of false lumen in aortic dissection.