Long-term Outcomes of Open Thoracoabdominal Aortic Repair in Connective Tissue Disease Patients: A 12-year Institutional Experience

Journal of Vascular Surgery · 2026-03-23

Ascending aorta to iliac artery bypass in coral reef aorta with multidrug resistant hypertension and worsening renal function

Journal of Vascular Surgery Cases and Innovative Techniques · 2026-01-08

Coral reef aorta is a rare condition characterized by heavily calcified atherosclerotic disease that involves the juxtarenal aorta, leading to potentially life-threatening complications (congestive heart failure, refractory hypertension, and visceral or limb ischemia). Here, we report the case of an elderly woman with resistant hypertension and worsening kidney function with a solitary right kidney, who underwent successful open surgical repair using the ascending aorta as an inflow source to a bypass graft to the renal, mesenteric and iliac arteries. This approach provides an effective and durable option for difficult coral reef aorta cases not amenable to other less invasive approaches.

Reoperations after the Ross procedure: Techniques, complexity, and outcomes

JTCVS structural and endovascular. · 2026-01-18

Type B Aortic Dissection in Patients Aged 30 Years or Younger: A Retrospective Multicentre Study

European Journal of Cardio-Thoracic Surgery · 2025-12-12

OBJECTIVES: Type B aortic dissection (TBAD) is rare in patients aged ≤30 years, and data on this population remain limited. This study aimed to characterize the underlying aetiology, and outcomes of invasively treated young patients with TBAD, with a focus on the impact of heritable thoracic aortic disease (HTAD). METHODS: A retrospective multicentre analysis was conducted across 19 international aortic centres, including 139 patients aged ≤30 years with TBAD. Patients with chronic TBAD (n = 42) were excluded for the final analysis. The cohort was classified as uncomplicated (n = 86) or complicated (n = 53) TBAD. Clinical, radiologic, intraoperative, and postoperative data were collected using standardized forms. Outcomes were compared between subgroups defined by TBAD complexity, HTAD status, and surgical strategy. Kaplan-Meier and Andersen-Gill analyses were used for survival and recurrent aortic intervention, respectively. RESULTS: Mean follow-up time was 6.5 years. HTAD was identified in 57% of patients. Most presented with uncomplicated TBAD (62%), while high-risk uncomplicated cases were uncommon. Endovascular repair was predominant in complicated TBAD, while open repair was more frequent in uncomplicated cases. Early mortality was low (n = 3), and mid-term survival was excellent across all subgroups. HTAD was a significant predictor of recurrent aortic interventions (HR = 3.3, P = .004). No significant differences were observed in survival or reintervention rates between uncomplicated and complicated TBAD or between operative strategies. CONCLUSIONS: In young patients, TBAD predominantly occurs in the context of HTAD. Both open and endovascular repair are associated with excellent early outcomes and mid-term survival. However, HTAD remains a significant predictor of recurrent aortic interventions.

Changes in ejection fraction after coronary artery bypass grafting for ischemic cardiomyopathy: Impact on survival and determinants of improvement

Journal of Thoracic and Cardiovascular Surgery · 2025-10-30 · 1 citations

A Novel Preoperative Risk Prediction Model of Non-home Discharge After Open Thoracoabdominal Aortic Aneurysm Repair

Journal of Vascular Surgery · 2025-05-23

Aortoesophageal fistula: Long-term survival with aggressive multidisciplinary management

JTCVS Techniques · 2025-09-25

Objective: Aortoesophageal fistula (AoEF) is a rare but complex problem that carries high mortality. This study describes our institutional experience with the management of AoEF. Methods: There were 17 patients with AoEF who were managed in our center (2005-2023). Medical records were reviewed for baseline characteristics, history of esophageal or aortic disease, diagnostic evaluation, surgical treatment, and follow-up. Overall survival (OS) was analyzed using the Kaplan-Meier method and log rank tests. Results: < .001). Conclusions: Management of AoEF is complex. However, aggressive multidisciplinary intervention with definitive esophageal and aortic repairs can result in good long-term survival in selected patients.

Partial diaphragm division is associated with decreased ventilator support after open thoracoabdominal aortic repair

Journal of Vascular Surgery · 2025-08-22

Treatment Trends and Outcomes of Endovascular versus Open Thoracoabdominal Aortic Aneurysm Repair – A Single-center Comparative Cohort Study

Annals of Surgery · 2025-07-25 · 2 citations

OBJECTIVE: To evaluate treatment trends and compare outcomes following fenestrated-branched endovascular aortic repair (FB-EVAR) versus open surgical repair (OSR) of thoracoabdominal aortic aneurysms (TAAA). BACKGROUND: FB-EVAR has been increasingly utilized as a less invasive alternative to OSR for treatment of TAAAs. METHODS: We studied patients who underwent elective FB-EVAR or OSR of TAAAs (2008-2020), since the initiation of an Advanced Endovascular Aortic Program. Primary endpoints were early major adverse events (MAE) and early and late all-cause mortality. Propensity score overlap weighting analysis was performed to adjust for measured confounders between groups. RESULTS: There were 357 (70.8%) patients treated by FB-EVAR and 147 (29.2%) with OSR. The use of FB-EVAR increased from 16.7% in 2008 to >80% since 2017 (P<0.001). Incidences of early MAEs were 25.8% and 49.0%, respectively; early mortality rates for FB-EVAR and OSR were 2.5% and 6.8%, respectively. In the weighted cohort, FB-EVAR patients had decreased early MAEs (weight-adjusted odds ratio [aOR], 0.28; 95% confidence interval [CI], 0.18-0.41; P<0.001) and mortality (aOR, 0.35; 95% CI, 0.17-0.73; P=0.005) versus OSR patients. Five-year survival estimates were 52.2% (95% CI, 45.2-60.4%) and 78.0% (95% CI, 70.6-86.2%), respectively. In the weighted cohort, there was no significant difference in late survival between groups (weight-adjusted hazard ratio, 1.33; 95% CI, 0.74-2.39; P=0.34). CONCLUSIONS: This study confirmed the change in practice from OSR to FB-EVAR for treatment of TAAAs over the past decade. Incidences of early MAEs and mortality were lower with FB-EVAR, with no significant difference in late survival in the weighted cohort.

Partial Diaphragm Division Is Associated With Decreased Ventilator Support After Open Thoracoabdominal Aortic Repair

Journal of Vascular Surgery · 2025-03-17