Multi-confocal fluorescence correlation spectroscopy.
1. Heart Surg Forum. 2018 Jun 18;21(4):E263-E268. doi: 10.1532/hsf.2004.
Perioperative Outcomes of Repeated Open Surgery on the Thoracic Aorta.
Shim H(1), Jeon CS, Park PW, Kim WS, Lee YT, Jeong DS, Cho YH, Sung K.
Author information:
(1)Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Korea.. .
ackground: Repeated thoracic aorta repair is increasingly common. With the
increase in hybrid procedures, determination of the best treatment strategy
requires evaluation of the clinical outcomes of classic open surgery. Methods:
We retrospectively reviewed 119 patients (84 men and 35 women, aged 51.0 ± 16.7
years) with a history of open repair involving the thoracic aorta above the
diaphragm. The patients underwent an average of 1.3 ± 0.8 surgeries (range: 1-8)
on the thoracic aorta before the final operation. Clinical outcomes were
evaluated on the basis of the need for emergency surgery, indications for
surgery, pathologic causes, and other operative variables.RESULTS: Hospital
mortality was 6.7% (n = 8). Postoperative bleeding occurred in 16% (n = 19). On
multivariable analysis, emergency surgery (odds ratio [OR], 19.005; P = .003; 95%
confidence interval [CI], 2.710-133.305) and cardiopulmonary bypass (CPB) time
(OR, 1.562 per 30 minutes; P = .007; 95% CI, 1.126-2.165) were predictors of
hospital death. Emergency surgery (OR, 4.105; P = .029; 95% CI, 1.157-14.567) and
CPB time (OR, 1.189 per 30 minutes; P = .035; 95% CI, 1.012-1.396) were also
associated with postoperative bleeding, in addition to surgery for an infectious
cause (OR, 10.824; P = .010; 95% CI, 1.755-66.770). Estimated survival at 1, 5,
and 7 years was 86.6%, 80.5%, and 78.2%, respectively. Conclusion: Despite the
variety of preoperative conditions and operations performed, repeated open
surgery for thoracic aorta repair can be performed with acceptable early and late
outcomes.
PMID: 30084776