초록접수 현황
| 20F-199 | 구연 발표 |
Is hybrid operation neurologically stable for aortic arch and proximal descending aortic lesion?
Euysuk Chung1,
Jaehoon Lee1
Sungjoon Park 2
1. Department of Cardiothoracic Surgery, School of Medicine, Inje University, Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, South Korea
2. Department of Thoracic and Cardiovascular Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
Purpose : Hybrid operation for aortic arch and the proximal descending aortic lesion has been widely performed. However, some reports warn of its neurological risk. To evaluate the postoperative neurological results, we planned this study.
Methods : Of the 30 patients who underwent endovascular surgery at our hospital, from September 2017 to July 2020, 19 patients with lesions in the aortic arch and proximal descending aorta (M: F 16:3 median 73yrs old (51-87), 15 aneurysms, 4 chronic dissection) were included this study. Brain CT was performed before surgery, and perfusion MRI was performed after surgery
Results : We performed the hybrid operation according to the location of the aortic lesion and landing zone (Zone0 2, Zone2 10, zone3 7). There were no operative mortality and early endoleaks. When comparing postoperative MRI and preoperative brain CT, 57.9% (11/19) of new acute embolic lesions were identified. However, all patients had no symptoms except one case. The presence of the debranching, type of aortic lesion did not affect the results, and the presence of calcium and aortic ulcer in the landing zone, and the presence of thrombus (>1cm) in the aneurysm were analyzed as risk factors (p<0.05). At the first visit after discharge, all patients were neurologically symptom-free and were observed with only aspirin.
Conclusion : Through this study, in the hybrid arch and proximal descending aortic surgery, we could confirm that there is a high rate of the silent lesion, but few clinically significant embolic events. In the future, We need effotrt to reduce embolic event and additional studies .
Methods : Of the 30 patients who underwent endovascular surgery at our hospital, from September 2017 to July 2020, 19 patients with lesions in the aortic arch and proximal descending aorta (M: F 16:3 median 73yrs old (51-87), 15 aneurysms, 4 chronic dissection) were included this study. Brain CT was performed before surgery, and perfusion MRI was performed after surgery
Results : We performed the hybrid operation according to the location of the aortic lesion and landing zone (Zone0 2, Zone2 10, zone3 7). There were no operative mortality and early endoleaks. When comparing postoperative MRI and preoperative brain CT, 57.9% (11/19) of new acute embolic lesions were identified. However, all patients had no symptoms except one case. The presence of the debranching, type of aortic lesion did not affect the results, and the presence of calcium and aortic ulcer in the landing zone, and the presence of thrombus (>1cm) in the aneurysm were analyzed as risk factors (p<0.05). At the first visit after discharge, all patients were neurologically symptom-free and were observed with only aspirin.
Conclusion : Through this study, in the hybrid arch and proximal descending aortic surgery, we could confirm that there is a high rate of the silent lesion, but few clinically significant embolic events. In the future, We need effotrt to reduce embolic event and additional studies .
책임저자: Euysuk Chung
Department of Cardiothoracic Surgery, School of Medicine, Inje University, Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, South Korea
발표자: Euysuk Chung, E-mail : kustricha@hanmail.net