Surgical Outcomes of Thoracoabdominal Aortic Surgery in patients who had previous aortic surgery through thoracotomy

P0320 

Abstract Submission 

muhyung Heo (1), Seyeon Jeon (1), Siwon Oh (1), suryeun chung (1), Yang Hyun Cho (1), Dong Seop Jeong (1), Wook Sung Kim (1), Kiick Sung (1)

(1) Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, NA

muhyung Heo    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Seyeon Jeon    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Siwon Oh    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

suryeun chung    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Yang Hyun Cho    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Dong Seop Jeong    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Wook Sung Kim    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Kiick Sung    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University

Seyeon Jeon    -  Contact Me
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center

Objective
Redo-thoracotomy due to aneurysmal changes in the residual aorta post-surgery presents challenges such as lung adhesions and lesion dissection difficulties. This study aims to scrutinize the outcomes of patients undergoing thoracoabdominal aorta replacement surgery with a prior left thoracotomy approach.

Methods
As a retrospective study at a single center, 214 patients were enrolled undergoing thoracoabdominal aortic aneurysm surgery from 1996 to 2023. A comparative analysis was performed between 30 patients who underwent redo-thoracotomy (redo group) and 184 patients who had their initial surgery through a thoracotomy (control group). Clinical outcomes, including early mortality and postoperative complications, were meticulously examined.

Results
Compared to the control group, the redo group exhibited a significantly younger median age (49.1 years vs. 60.2 years, p=0.019). Connective tissue disease was more prevalent in the redo group (50% vs. 29.9%, p=0.049). In the control group, Crawford type 2 and type 3 distributions were 47.3% and 23.4%, respectively, while the redo group predominantly featured type 3 (83.3%) (p<0.001). Surgical parameters, including total surgical time, cardiopulmonary bypass (CPB) time, and aortic cross-clamp (ACC) time, did not exhibit statistically significant differences between the two groups.
Postoperative outcomes, such as 30-day mortality, showed no significant difference between the redo group (3.3%) and the control group (5.4%) (p>0.999). The incidence of postoperative complications did not differ significantly between the two groups; paraplegia (0% vs. 4.3%, p=0.589), postoperative bleeding (10.0% vs. 8.7%, p>0.999), continuous renal replacement therapy (CRRT) use (10.0% vs. 10.9%, p>0.999), pneumonia rates (3.3% vs. 2.6%, p=0.589), and median post-surgery ventilation time (14.0 hours vs. 15.9 hours, p=0.223), did not significantly differ between the redo and control groups.

Conclusion
The study suggests that outcomes following redo-thoracotomy for thoracoabdominal aorta replacement surgery are not significantly worse than anticipated.

Descending/Thoracoabdominal Aorta