J Vasc Surg. 2011 Mar;53(3):600-7; discussion 607 doi: 10.1016/j.jvs.2010.09.053. 2010 Nov 26.

Effect of chronic dissection on early and late outcomes after descending thoracic and thoracoabdominal aneurysm repair

Conrad MF, Chung TK, Cambria MR, Paruchuri V, Brady TJ, Cambria RP.

Abstract

OBJECTIVE: Although chronic aortic dissection (CD) has traditionally been considered a predictor of perioperative morbidity and mortality after descending thoracic/thoracoabdominal aneurysm repair (thoracoabdominal aortic aneurysm [TAA]), recent reports have rejected this assertion. Still, few contemporary studies document late outcomes after TAA for CD, which is the goal of this study.
METHODS: From August 1987 to December 2005, 480 patients underwent TAA; 73 (15%) CD and 407 (85%) degenerative aneurysms (DA). Operative management consisted of a clamp-and-sew technique with adjuncts in 53 (78%) CD and 355 (93%) DA patients (P RESULTS: CD patients were younger (mean age 64.5 years CD vs 72.5 years DA, P CONCLUSIONS: Despite increased operative complexity, CD does not appear to increase perioperative SCI or mortality after TAA when compared with DA. Long-term freedom from aneurysm-related reintervention is similar for both groups as is survival, despite patients with CD being of younger age at presentation.

PMID: 21112177