Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2026
Isolated Ascending Aortic Aneurysms: Five-Year Comparative Outcomes between Modified Wrapping Technique and Supracoronary Tube Replacement.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Dubrulle Henri, Coisne Augustin, Aghezzaf Samy, Bardeesi Adham, Bical Antoine, Pontana François, Montaigne David, Modine Thomas, Vincentelli André, Koussa Mohammad
Аннотация
PURPOSE: This study aimed to compare outcomes of the modified wrapping technique (MWT) and supracoronary tube replacement (STR) for isolated ascending aortic aneurysms, focusing on perioperative safety, 5-year survival, and arterial stiffness.
METHODS: This retrospective, single-center study included 205 patients undergoing MWT (n = 91) or STR (n = 114) between 2006 and 2019 for isolated ascending aortic aneurysms ≥50 mm or rapidly progressing lesions. A prospective substudy evaluated arterial stiffness using the SphygmoCor system in a matched subgroup of 40 patients. The primary endpoint was 5-year survival; secondary endpoints included perioperative outcomes, prosthetic infection, and hemodynamic indices.
RESULTS: MWT showed significantly shorter cardiopulmonary bypass and aortic cross-clamp times (p <0.0001) and reduced hospital stay (10.5 ± 0.3 vs. 13.5 ± 0.8 days; p = 0.001). In-hospital mortality tended to be lower with MWT (0% vs. 4.4%; p = 0.06). Five-year survival was comparable between groups (88.1% vs. 83.4%; p = 0.17). Prosthetic infection was significantly lower in the MWT group (1.1% vs. 7.0%; p = 0.04). Hemodynamic assessment demonstrated lower pulse wave velocity and aortic augmentation index in the MWT group.
CONCLUSIONS: MWT was associated with shorter operative times and lower prosthetic infection rates while maintaining similar early and mid-term survival compared with STR. These findings suggest MWT as a valuable alternative in selected patients.
METHODS: This retrospective, single-center study included 205 patients undergoing MWT (n = 91) or STR (n = 114) between 2006 and 2019 for isolated ascending aortic aneurysms ≥50 mm or rapidly progressing lesions. A prospective substudy evaluated arterial stiffness using the SphygmoCor system in a matched subgroup of 40 patients. The primary endpoint was 5-year survival; secondary endpoints included perioperative outcomes, prosthetic infection, and hemodynamic indices.
RESULTS: MWT showed significantly shorter cardiopulmonary bypass and aortic cross-clamp times (p <0.0001) and reduced hospital stay (10.5 ± 0.3 vs. 13.5 ± 0.8 days; p = 0.001). In-hospital mortality tended to be lower with MWT (0% vs. 4.4%; p = 0.06). Five-year survival was comparable between groups (88.1% vs. 83.4%; p = 0.17). Prosthetic infection was significantly lower in the MWT group (1.1% vs. 7.0%; p = 0.04). Hemodynamic assessment demonstrated lower pulse wave velocity and aortic augmentation index in the MWT group.
CONCLUSIONS: MWT was associated with shorter operative times and lower prosthetic infection rates while maintaining similar early and mid-term survival compared with STR. These findings suggest MWT as a valuable alternative in selected patients.
Предметные рубрики MeSH
HumansFemaleTime FactorsRetrospective StudiesBlood Vessel Prosthesis ImplantationMaleAgedRisk FactorsHospital MortalityBlood Vessel ProsthesisAneurysm, Ascending AortaTreatment OutcomeVascular StiffnessMiddle AgedRisk AssessmentLength of StayHemodynamicsProsthesis DesignProsthesis-Related InfectionsAged, 80 and over