Prospective Study Needed To Determine If Hybrid Thoracoabdominal Aneurysm Repair Is Less Morbid Than Standard Open Repair

Main Category: Cardiovascular / Cardiology
Article Date: 24 Nov 2008 - 4:00 PDT

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The repair of thoracoabdominal aneurysms (TAA) by means of open surgery in patients who are poor surgical candidates has significant morbidity and mortality rates associated with it.

"The repair of TAAs by means of a hybrid procedure (HTAA) using endovascular and open surgical techniques may reduce the morbidity and mortality in poor candidates for open repair (OTAA)," states Dr. Richard Cambria, Professor of Surgery at the Harvard Medical School and Chief, Division of Vascular and Endovascular Surgery at Massachusetts General Hospital.

He described a retrospective study that compared patients who underwent HTAA (23) with OTAA (77).

The study's major endpoints were 30-day composite mortality rate and permanent paraplegia (PP). Interestingly, the mortality, re-intervention, and paraplegia rates were all higher in the HTAA group.

Dr. Cambria said that these results suggest that perhaps a non-interventional approach may be appropriate in high-risk patients. Even when results in the small number of lower risk patients are examined, patients who underwent HTAA had higher morbidity and mortality rates than those patients who underwent OTAA.

Dr. Cambria concluded that only a prospective study will ultimately be able to define the role of HTAA repair.

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Source
Pauline T. Mayer
www.ptmhcm.com