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Shlomin V.V.

St. Petersburg City Multi-Field Hospital No. 2

Bondarenko P.B.

Mechnikov North-West State Medical University

Gusinsky A.V.

Almazov National Medical Research Center

Puzdryak P.D.

Mechnikov North-West State Medical University

Shloydo E.A.

City Multi-Field Hospital No. 2, St. Petersburg

Yurtaev E.A.

St. Petersburg Multi-field Hospital No. 2

Didenko Yu.P.

St. Petersburg City Multi-field Hospital No. 2

Grebenkina N.Yu.

St. Petersburg City Multi-Field Hospital No. 2

Kasyanov I.V.

St. Petersburg City Multi-field Hospital No. 2

Korovin I.V.

St. Petersburg City Multi-field Hospital No. 2

Chizhova K.A.

Mechnikov Northwestern State Medical University

Twenty-year experience in off-pump surgery for thoracic and thoracoabdominal aorta aneurysms and dissections

Authors:

Shlomin V.V., Bondarenko P.B., Gusinsky A.V., Puzdryak P.D., Shloydo E.A., Yurtaev E.A., Didenko Yu.P., Grebenkina N.Yu., Kasyanov I.V., Korovin I.V., Chizhova K.A.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(4): 266‑275

DOI: 10.17116/kardio202114041266

Views: 729

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To cite this article:

Shlomin VV, Bondarenko PB, Gusinsky AV, et al. . Twenty-year experience in off-pump surgery for thoracic and thoracoabdominal aorta aneurysms and dissections. Russian Journal of Cardiology and Cardiovascular Surgery. 2021;14(4):266‑275. (In Russ.)
https://doi.org/10.17116/kardio202114041266

 
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OBJECTIVE

To analyze own experience and to determine the most optimal off-pump surgery for thoracic and thoracoabdominal aorta aneurysms and dissections.

MATERIAL AND METHODS

A retrospective analysis included 150 patients. Lesion of aortic arch and descending thoracic aorta was diagnosed in 86 (57%) cases, thoracoabdominal aortic aneurysm Crawford type Ι—ΙV — 54 (36%) patients, type B aortic dissection with malperfusion syndrome — 10 (7%) cases. All patients were divided into 2 groups. In the first group, open surgical interventions have been performed until 2010. Open, endovascular and hybrid procedures were used in the second group after 2010. Temporary synthetic bypass graft 14—16 mm was used for open surgery.

RESULTS

Over the follow-up period, 30-day mortality after thoracic and thoracoabdominal aorta surgery was reduced from 25 to 9% (elective interventions — from 18 to 7%, emergency surgery — from 33 to 17%). Long-term 5-year survival was 72% and did not differ between groups. Higher incidence of redo interventions and aorta-associated complications was noticed after endovascular surgery. It was concluded that hybrid and endovascular treatment is preferred for aortic arch and descending thoracic aorta repair, open and hybrid methods — for thoracoabdominal aorta repair.

CONCLUSION

Endovascular and hybrid technologies significantly reduced the incidence of postoperative complications and mortality after off-pump thoracic and thoracoabdominal aorta surgery.

Keywords:

thoracoabdominal aneurysm
thoracic endovascular aortic repair
delayed complications after endovascular aortic repair
temporary aortic bypass

Authors:

Shlomin V.V.

St. Petersburg City Multi-Field Hospital No. 2

Bondarenko P.B.

Mechnikov North-West State Medical University

Gusinsky A.V.

Almazov National Medical Research Center

Puzdryak P.D.

Mechnikov North-West State Medical University

Shloydo E.A.

City Multi-Field Hospital No. 2, St. Petersburg

Yurtaev E.A.

St. Petersburg Multi-field Hospital No. 2

Didenko Yu.P.

St. Petersburg City Multi-field Hospital No. 2

Grebenkina N.Yu.

St. Petersburg City Multi-Field Hospital No. 2

Kasyanov I.V.

St. Petersburg City Multi-field Hospital No. 2

Korovin I.V.

St. Petersburg City Multi-field Hospital No. 2

Chizhova K.A.

Mechnikov Northwestern State Medical University

Received:

29.09.2020

Accepted:

22.10.2020

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