P320. Surgical Outcomes of Thoracoabdominal Aortic Surgery in patients who had previous aortic surgery through thoracotomy
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Samsung Hospital
seoul, NA
South Korea - Contact Me
2016-2017 Internship at Hanyang university hospital
2017-2021 Residents, Department of thoracic and cardiovadcular surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2022- present, clinical fellow, Division of Cardiovascular surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
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.
Authors
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)
Institutions
(1) Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, NA
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.
Authors
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)
Institutions
(1) Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, NA
Presentation Duration
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