Clinical observation of thoracic endovascular aortic repair for emergency treatment of thoracic aortic rupture
Objective: To investigate the clinical indications and effectiveness of endovascular aortic repair (TEVAR) emergency treatment of thoracic aortic rupture, and overview the relevant clinical experience. Methods: The clinical data of patients with thoracic aortic rupture admitted and treated from January 2006 to September 2015 in Department of Cardiothoracic Surgery, Wuhan General Hospital of PLA were retrospectively analyzed. Results: A total of 51 patients with thoracic aortic rupture (due to rupture of thoracic aortic dissecting aneurysm in 15 cases, thoracic aorta trauma in 32 cases and aortoesophageal fistula in 4 cases) who underwent emergency treatment of TEVAR procedure were retrieved. Of the 51 patients, 4 cases died during the initial treatment prior to TEVAR, and 47 cases received successful TEVAR operation; 6 cases (3 cases having aortoesophageal fistula) died after operation, while no serious complications occurred in the remaining 41 cases, in whom, no death occurred within postoperative one month. All cases were followed up at postoperative 3 months, 6 months and one year. By the end of May 2016, 36 cases received complete follow- up, the mean follow- up time was 56.6 months (range, 6 to 123 months); of these, the follow-up time after operation in one case was 6 months, in 4 cases was 12 months and in one case was 24 months. At follow-up, all the patients were in good health, and with no complications such as endoleak, stenosis or blockage of the bypass graft. Conclusion: TEVAR is a rapid and effective treatment modality for thoracic aortic rupture.