Technical aspects of branched graft aortic reconstruction in patients with connective tissue disorders

J Vasc Surg. 2016 Aug;64(2):520-525. doi: 10.1016/j.jvs.2016.04.044. Epub 2016 Jun 7.

Abstract

Connective tissue disorders (CTDs) predispose patients to dilation of the entire aorta, resulting in the development of extensive aneurysms. Aortic reconstruction in CTD patients can be challenging and demands specific approaches to ensure initial success and lasting stability of aortic repair. Herein, we describe technical approaches to aortic reconstruction in patients with CTDs and briefly report our outcomes on the use of branched grafts for reconstruction in this unique population of patients. We conclude that aortic reconstruction in CTD patients with branched grafts can be performed safely, with a low morbidity and mortality and excellent branch patency. Branched surgical grafts should be used preferentially over the inclusion patch technique during open repair to minimize the late development of patch aneurysms.

MeSH terms

  • Adult
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / physiopathology
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / etiology
  • Aortic Aneurysm, Thoracic / mortality
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis Implantation / mortality
  • Blood Vessel Prosthesis*
  • Computed Tomography Angiography
  • Connective Tissue Diseases / complications*
  • Connective Tissue Diseases / diagnosis
  • Connective Tissue Diseases / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / instrumentation*
  • Plastic Surgery Procedures / mortality
  • Prosthesis Design
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Patency