Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

• Main Authors: Jae-Sung Choi, Se Jin Oh, Yong Won Sung, Hyun Jong Moon, Jung Sang Lee
• Format: Article
• Language: English
• Published: Korean Society for Thoracic and Cardiovascular Surgery 2016-04-01
• Series: Korean Journal of Thoracic and Cardiovascular Surgery
• Subjects: Aneurysm; Aorta; Rupture; Stents
• Online Access: http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2016.49.2.73

Background: The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition. Methods: Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA. Results: The mean age was 72.4±5.1 years, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was 269.8±72.3 minutes. The mean total length of aortic coverage was 186.0±49.2 mm. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of 16.8±14.8 months, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown. Conclusion: TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.