Levent YILIK, Ali GÜRBÜZ, Orhan GÖKALP, Yüksel BEŞİR, Hasan İNER, Banu LAFCI, Nihan KARAKAŞ YEŞİLKAYA, Kazım ERGÜNEŞ

Arkus aort anevrizmalarının tedavisi: Açık cerrahi mi hibrid işlem mi?

Amaç: Bu çalışmada arkus aort anevrizmalarının tedavisinde hibrid işlem ve açık cerrahi sonuçları karşılaştırıldı. Çalışma planı: Ocak 2004 - Ocak 2010 tarihleri arasında arkus aort anevrizması nedeniyle total arkus aort replasmanı yapılan 26 hasta (21 erkek, 5 kadın; ort. yaş 56.6±12.4 yıl; dağılım, 20-83 yıl) retrospektif olarak değerlendirildi. Hastalar açık konvansiyonel cerrahi grubu (grup 1, n=15) ve hibrid işlem (aynı seansta total arkus aort debranching ve endovasküler stent implantasyonu) grubu (grup 2, n=11) olarak iki gruba ayrıldı. Sağkalım oranları ve tekrar ameliyat gereksinimi gruplar arasında karşılaştırıldı. Bulgular: Ameliyat sonrası revizyon, ekstübasyon süresi ve drenaj miktarları açısından hibrid işlem daha iyi bulundu. Ancak sağkalım oranları, tekrar ameliyat gereksinimi ve ciddi advers kardiyovasküler olaylar açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktu. Sonuç: Çalışma sonuçlarımız arkus aort anevrizması nedeniyle total arkus aort replasmanı yapılan hastalarda sağkalım ve kısa ila orta dönem sonuçlar açısından açık konvansiyonel cerrahi ve hibrid işlemin benzer olduğunu göstermektedir.

Treatment of aortic arch aneurysms: Open surgery or hybrid procedure?

Background: This study aims to compare the results of hybrid procedure and open surgery for the treatment of aortic arch aneurysms. Methods: Twenty-six patients (21 males, 5 females; mean age 56.6±12.4 years; range, 20 to 83 years) who underwent total aortic arch replacement for aortic arch aneurysm between January 2004 and January 2010 were retrospectively analyzed. The patients were divided into two groups: open conventional surgery group (group 1, n=15) and hybrid procedure (total debranching of the aortic arch and simultaneous endovascular stent) group (group 2, n=11). Survival rates and need for reoperation were compared between the groups.Results: The hybrid procedure was found to be more favorable in terms of postoperative revision, extubation period, and drainage amounts. However, there was no statistically significant difference in the survival rates, need for reoperation, and major adverse cardiovascular events between the groups.Conclusion: Our study results suggest that conventional open surgery and hybrid procedure are similar in terms of survival and short-to-mid-term results in patients undergoing total aortic arch replacement for aortic arch aneurysm.

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