ASIAN CARDIOVASCULAR & THORACIC ANNALS最新文献

{"title":"Corrigendum.","authors":"","doi":"10.1177/02184923231200760","DOIUrl":"10.1177/02184923231200760","url":null,"abstract":"","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"743"},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national incidence, mortality, and disability-adjusted life years of non-rheumatic valvular heart disease and trend analysis from 1990 to 2019: Results from the Global Burden of Disease study 2019.","authors":"Kan Wang,&nbsp;Bingchuan Geng,&nbsp;Qiang Shen,&nbsp;Yixuan Wang,&nbsp;JiaWei Shi,&nbsp;NianGuo Dong","doi":"10.1177/02184923231200695","DOIUrl":"10.1177/02184923231200695","url":null,"abstract":"<p><strong>Background: </strong>In the context of the population growing and aging worldwide, the incidence of non-rheumatic valvular heart disease increased rapidly. This study aimed to describe the burden of non-rheumatic valvular heart disease, providing an up-to-date and comprehensive analysis on the global and regional levels and time trends from 1900 to 2019.</p><p><strong>Methods: </strong>The Global Burden of Disease 2019 was used to obtain data for this analysis. Non-rheumatic valvular heart disease in the Global Burden of Disease study includes both non-rheumatic calcific aortic valve disease and non-rheumatic degenerative mitral valve disease. The incidence, mortality, and disability-adjusted life year in 204 countries from 1990 to 2019 were analyzed by location, year, sex, age, and socio-demographic index. Estimated annual percentage change was calculated to represent the temporal trends from 1990 to 2019. Spearman's rank order correlation was used to determine the correlation between socio-demographic index and the incidence and burden of non-rheumatic valvular heart disease.</p><p><strong>Results: </strong>Globally, there were 1.65 million (95% uncertainty interval, 1.56-1.76 million) incident cases, 0.16 million (95% uncertainty interval, 0.14-0.18 million) death cases, and 2.79 million (95% uncertainty interval, 2.52-3.31 million) disability-adjusted life years of non-rheumatic valvular heart disease. Compared with 1990, the number of incident cases, death cases, and disability-adjusted life years in 2019 increased by 104.58%, 210.60%, and 167.62%, respectively, the age-standardized incidence rate (estimated annual percentage change, 0.39; 95% confidence interval, 0.29 to 0.49) increased due to population growth, and the age-standardized death rates (estimated annual percentage change, -0.32; 95% confidence interval, -0.39 to -0.25) and age-standardized disability-adjusted life year rate (estimated annual percentage change, -0.81; 95% confidence interval, -0.87 to -0.74) decreased during this period. Regarding the socio-demographic index, the highest age-standardized incidence, death, and disability-adjusted life year rates of non-rheumatic valvular heart disease were found in high-socio-demographic index countries in 2019. Meantime, the age-standardized incidence rate remained increased from 1990 to 2019, while significant decreases were found in the age-standardized death rate and age-standardized disability-adjusted life year rate. Females have higher age-standardized incidence rate, while higher age-standardized death rate and age-standardized disability-adjusted life year rate belong to males globally during the period of 1990-2019. Increasing trends were observed for both incidence, death, and disability-adjusted life year rates with age. High systolic blood pressure was the leading cause for non-rheumatic valvular heart disease across all ages.</p><p><strong>Conclusions: </strong>From 1990 to 2019, the age-standardized inci","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"706-722"},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac magnetic resonance imaging for myocardial viability assessment: Optimizing surgical revascularization in ischemic heart disease.","authors":"Azhar Sayyed,&nbsp;Subhajit Das,&nbsp;Patralekha Das,&nbsp;Sufina Shales,&nbsp;Lalit Kapoor,&nbsp;Atanu Saha,&nbsp;Pradeep Narayan","doi":"10.1177/02184923231199147","DOIUrl":"10.1177/02184923231199147","url":null,"abstract":"<p><strong>Background: </strong>Patients with poor ejection fraction undergoing coronary artery bypass grafting carry higher operative risk and have poor long-term survival. Cardiac magnetic resonance is a useful modality to assess viability which can identify patients likely to benefit most from revascularization. In this study, we aimed to assess the outcome in patients selected for surgical revascularization by cardiac magnetic resonance imaging and identify predictors associated with poor outcomes.</p><p><strong>Methods: </strong>The study included patients with severely impaired left ventricular function but with at least six viable segments. Patients requiring emergency surgery, undergoing combined procedures, or where cardiopulmonary bypass was required were excluded. Cardiac magnetic resonance was carried out both preoperatively and at six months postoperatively by the same radiologist in all cases. Late gadolinium enhancement was used for the evaluation of myocardial viability.</p><p><strong>Results: </strong>Amongst a total of 493 segments studied, there were 89 (18.1%) non-viable, 117 (23.7%) hibernating and 287 (58.2%) viable segments. At six months, the number of non-viable segments changed from 89 (18.1%) to 97 (19.7%), with an increase in viable segments from 287 (58.2%) to 374 (75.8%) and a corresponding reduction of hibernating segments from 117 (23.7%) to 22 (4.5%). There was improvement in ejection fraction from 28 ± 5.54 to 37 ± 5.86 (<i>p</i> < 0.0001) in the entire cohort at six months. Overall mortality was 1 (3.2%). Preoperative left ventricular end-systolic volume had the strongest negative correlation with post-operative ejection fraction.</p><p><strong>Conclusion: </strong>Cardiac magnetic resonance aided revascularization is associated with low mortality. Preoperative left ventricular end-systolic volume is an important determinant of postoperative ejection fraction.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"691-698"},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete surgical revascularization after NSTEMI and unstable angina in patients with multivessel coronary artery disease: Institutional experience.","authors":"Ibrahim C Kaya,&nbsp;Halil I Bulut,&nbsp;Katherine Candelario,&nbsp;Merih Ozbayburtlu,&nbsp;Ozan O Balkanay","doi":"10.1177/02184923231197872","DOIUrl":"10.1177/02184923231197872","url":null,"abstract":"Introduction The feasibility and standardization of coronary artery bypass grafting (CABG) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and unstable angina (UA) remain topics of ongoing debate. In this study, feasibility and early-term outcomes of CABG in patients with NSTE-ACS and UA were discussed. Methods This study enrolled 79 patients who underwent on-pump CABG with complete revascularization between January 2020 and May 2022. the survival rates analyzed using Kaplan Meier test with log rank test. The p value of statistical significance was taken as below 0.05. Results Preoperatively, the patients had a mean age of 60.9 years and a BMI of 28.0. The medical history included hypertension (50.6%), peripheral arterial disease and atrial fibrillation (12.7%), and other comorbidities such as COPD (22.8%) and type 2 diabetes mellitus (44.3%). Intraoperatively, the mean distal anastomosis count was 3.4, with average cardiopulmonary bypass and aortic cross-clamp times of 84.0 and 49.0 min, respectively. Early-term outcomes revealed low rates of mortality (2.5%) and complications such as myocardial infarction (1.3%), acute kidney injury (5.1%) and transient ischemic attack (5.1%). Post-discharge outcomes demonstrated low cardiac and all-cause mortality rates (2.5% and 3.8%, respectively) and a high overall survival rate (93.7%) at 12-month follow-up. Conclusion This study demonstrated the feasibility and positive outcomes of complete surgical revascularization in patients with UA and NSTE-ACS. It showed no graft occlusion or stroke, low complication rates and promising survival outcomes. Further research is needed for confirmation and to establish the procedure's efficacy and safety in this patient population.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"675-681"},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short stature is a risk factor for heart transplant morbidity and mortality.","authors":"Noah Weingarten,&nbsp;Amit Iyengar,&nbsp;Mrinal Patel,&nbsp;Samuel T Kim,&nbsp;Max Shin,&nbsp;Pavan Atluri","doi":"10.1177/02184923231197691","DOIUrl":"10.1177/02184923231197691","url":null,"abstract":"<p><strong>Background: </strong>Short stature is associated with mortality after cardiac surgery and may increase size mismatch risk among transplant recipients. Yet, stature's impact on heart transplant outcomes is not well-characterized.</p><p><strong>Methods: </strong>The Scientific Registry of Transplant Recipients was queried for data on all adult heart transplants in the United States from 2000 to 2022. Recipients were stratified into five cohorts by sex-corrected stature. Morbidity was assessed with Kruskal-Wallis and chi-squared tests. Mortality was analyzed using Kaplan-Meier estimation. Risk factors for mortality were assessed with multivariable Cox regression.</p><p><strong>Results: </strong>Among 43,420 transplant recipients, 5321 (12.2%) had short stature (females >4'11″ & ≤5'1″; males >5'4″ & ≤5'7″) and 765 (1.8%) had very short stature (females ≤4'11″; males ≤5'4″). Very short stature patients had higher waitlist status (1A and 1), more congenital heart disease, and received more oversized donor hearts than other cohorts (all <i>p</i> < 0.05). Very short stature patients had decreased 30-day, 1-, 5-, and 10-year survival (94.6%, 84.3%, 69.3% and 52.5%, respectively, all <i>p</i> < 0.001), but less acute rejection (<i>p</i> = 0.005) and comparable stroke rates (<i>p</i> = 0.107). On multivariable regression adjusting for congenital heart disease and oversized donor hearts, very short and short stature were associated with 10-year mortality (hazard ratios: 1.40 and 1.12, respectively, both <i>p</i> < 0.005).</p><p><strong>Conclusions: </strong>Short stature confers increased mortality risk for heart transplant recipients and merits inclusion in prognostic models.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"682-690"},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10147357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population risk profile analysis of acute uncomplicated type B aortic dissection patients undergoing thoracic endovascular aortic repair.","authors":"Mohammed Al-Tawil,&nbsp;Alexander Geragotellis,&nbsp;Matti Jubouri,&nbsp;Sven Zcp Tan,&nbsp;Idhrees Mohammed,&nbsp;Ian Williams,&nbsp;Mohamad Bashir","doi":"10.1177/02184923221099771","DOIUrl":"https://doi.org/10.1177/02184923221099771","url":null,"abstract":"<p><strong>Background: </strong>Uncomplicated type B aortic dissection (unTBAD) comprises the estimated majority of type B aortic dissection (TBAD), presenting without any of the complications associated with complicated TBAD (coTBAD). Although first-line treatment for coTBAD is thoracic endovascular aortic repair (TEVAR), and despite the fact that TEVAR has proven its safety and effectiveness in the treatment of unTBAD, unTBAD is still being predominantly managed conservatively with medical therapy, with a small proportion of patients being offered TEVAR.</p><p><strong>Aims: </strong>The main scope of this review is to highlight the evidence in the literature of the demographic characteristics and associated co-morbidities of unTBAD patients undergoing TEVAR in order to produce a risk stratification system to achieve favourable outcomes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using multiple electronic databases including PubMed, Ovid, Scopus, and EMBASE.</p><p><strong>Results: </strong>Multiple demographic characteristics and associated co-morbidities of unTBAD patients affecting TEVAR outcomes were identified, assessed, and investigated, including age, gender, race, genetics, medical conditions, such as hypertension and diabetes, and lifestyle factors such as smoking. Most factors were associated with increased risks of mortality and morbidity, while others, such as race, were identified as being protective against those when it comes to TEVAR.</p><p><strong>Conclusion: </strong>Despite the favourable results yielded by TEVAR in unTBAD, there remains a grey area concerning its management. Thus, it is important to incorporate the demographics and co-morbidities of unTBAD patients' when into clinical judgement when assessing indications for TEVAR intervention to ensure optimum results can be achieved.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"549-556"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10247765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient longevity and survival with custom-made endovascular solutions: The Fenestrated Anaconda^TM approach.","authors":"Matti Jubouri,&nbsp;Abdelaziz O Surkhi,&nbsp;Sven Z C P Tan,&nbsp;Damian M Bailey,&nbsp;Ian M Williams","doi":"10.1177/02184923231158579","DOIUrl":"https://doi.org/10.1177/02184923231158579","url":null,"abstract":"Background Endovascular aortic repair (EVAR) has become the mainstay treatment for abdominal aortic aneurysms and is associated with excellent clinical outcomes. However, there remains a risk of complications requiring reintervention. Several EVAR devices exist commercially, yet, the Terumo Aortic Fenestrated Anaconda™ has demonstrated outstanding results. The main scope of this study is to evaluate survival/longevity, target vessel patency (TVP), endograft migration and reintervention following Fenestrated Anaconda™ implantation and discuss relevant literature. Methods The current study represents a 9-year cross-sectional international analysis of custom-made Fenestrated Anaconda™ device. For the statistical analysis, SPSS 28 for Windows and R was utilised. Pearson Chi-Square analysis was used to assess differences in cumulative distribution frequencies between variables. Statistical significance for all two-tailed tests was set at p < 0.05. Results A total of 5058 patients received the Fenestrated Anaconda™ endograft. The Fenestrated Anaconda™ was indicated either due to complex anatomy for competitor devices (n = 3891, 76.9%) or based on surgeon preference (n = 1167, 23.1%). Both survival and TVP were 100% during the first 6 postoperative years but dropped to 77.1% and 81% thereafter. In the complex anatomy indication group, cumulative survival and TVP were both 100% until year 7 post-EVAR when they decreased to 82.8% and 75.7%. In the other indication group, survival and TVP were also 100% during the first 6 years but plateaued at 58.1% and 98.8% in years 7–9 of follow-up. No cases of endograft migration and reintervention were recorded. Conclusion The Fenestrated Anaconda™ has been proven across the literature to be a highly effective EVAR endograft, as it has demonstrated excellent survival/longevity and TVP as well as minimal endograft migration and reintervention.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"615-623"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of patient demographics and intraoperative characteristics on abdominal aortic aneurysm sac following endovascular repair.","authors":"Weronika Nocun,&nbsp;Rodrigo Muscogliati,&nbsp;Mohammed Al-Tawil,&nbsp;Matti Jubouri,&nbsp;Ayah S Alsmadi,&nbsp;Abdelaziz O Surkhi,&nbsp;Damian M Bailey,&nbsp;Ian M Williams,&nbsp;Mohamad Bashir","doi":"10.1177/02184923231178704","DOIUrl":"https://doi.org/10.1177/02184923231178704","url":null,"abstract":"<p><strong>Background: </strong>Endovascular aortic repair (EVAR) has become the preferred treatment for abdominal aortic aneurysm (AAA). Its main aim is to seal the perfusion of the aneurysmal sac and, thus, induce sac regression and subsequent aortic remodelling. Aneurysmal sac regression has been linked to the short- and long-term clinical outcomes post-EVAR. It has also been shown to be influenced by endograft device choice, with several of these available commercially. This review summarises and discusses current evidence on the influence of pre- and intraoperative factors on sac regression. Additionally, this review aims to highlight the device-specific variations in sac regression to provide an overall holistic approach to treating AAAs with EVAR.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using multiple electronic databases to identify and extract relevant data.</p><p><strong>Results: </strong>Female sex, >70 mm original sac diameters, higher pre-procedural fibrinogen levels, smoking and low intra-aneurysmal pressure were found to positively impact sac regression. Whereas renal impairment, ischemic heart disease, high intra-aneurysmal pressure and aneurysm neck thrombus negatively influenced sac regression. Patent lumbar arteries, age, statins and hypercholesterolaemia displayed conflicting evidence regarding sac regression. Regarding the EVAR endografts compared, newer generation devices such as the Anaconda mainly showed the most optimal results.</p><p><strong>Conclusion: </strong>Sac regression following EVAR in AAA is an important prognostic factor for morbidity and mortality. Nevertheless, several pre- and intraoperative factors can have an influence on sac regression. Therefore, it is necessary to take them into account when assessing AAA patients for EVAR to optimise outcomes. The choice of EVAR stent-graft can also affect sac regression, with evidence suggesting that the Fenestrated Anaconda is associated with the most favourable results.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"633-643"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoraflex Hybrid vs. AMDS: To replace the arch or to stent it in type A aortic dissection?","authors":"Mohammed Al-Tawil,&nbsp;Matti Jubouri,&nbsp;Sven Zcp Tan,&nbsp;Damian M Bailey,&nbsp;Ian M Williams,&nbsp;Giovanni Mariscalco,&nbsp;Gabrielle Piffaretti,&nbsp;Edward P Chen,&nbsp;Bashi Velayudhan,&nbsp;Idhrees Mohammed,&nbsp;Mohamad Bashir","doi":"10.1177/02184923221147442","DOIUrl":"https://doi.org/10.1177/02184923221147442","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (ATAAD) is a life-threatening medical emergency that requires urgent surgical intervention. The mainstay surgical approach to treating ATAAD with aortic arch involvement is total arch replacement (TAR). The frozen elephant trunk (FET) procedure involves TAR with hybrid endovascular stenting of the DTA in a single step using a hybrid prosthesis (HP). The prime example of a FET HP is Thoraflex Hybrid Prosthesis (THP). Another treatment option is the novel Ascyrus Medical Dissection Stent (AMDS) that is deployed as a non-covered stent along with the aortic arch as an adjunct to prior hemi-arch replacement.</p><p><strong>Aims: </strong>This comparative review highlights the clinical applications and outcomes of THP and AMDS in the treatment of ATAAD and discusses the main differences between both approaches.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using multiple electronic databases including PubMed, Google Scholar, Ovid, Scopus and Embase.</p><p><strong>Results: </strong>TAR with FET can be considered the superior approach to managing ATAAD with arch involvement relative to AMDS with hemi-arch replacement due to more optimal clinical outcomes. Upon comprehensively searching the literature, early mortality was substantially lower with FET ranging from 0-11% compared to 12.5-18.7% using AMDS, with more favourable long-term survival. The incidence of kidney injury and new stroke post-FET ranged from 3-20% and 5-16%, and 11-37.5% and 0-18.8% following AMDS implantation. However, evidence supporting the use of AMDS is extremely limited. Meanwhile, TAR with FET is a well-established and well-described procedure for ATAAD repair.</p><p><strong>Conclusion: </strong>Despite the novel nature of AMDS, its clinical safety and effectiveness are yet to be proven. In conclusion, THP remains the best evidenced-based approach to treat ATAAD in this era.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"596-603"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can the Fenestrated Anaconda™ salvage failed competitor endografts? An international frame of reference.","authors":"Matti Jubouri,&nbsp;Abdelaziz O Surkhi,&nbsp;Sven Z C P Tan,&nbsp;Damian M Bailey,&nbsp;Ian M Williams,&nbsp;Mohamad Bashir","doi":"10.1177/02184923221138505","DOIUrl":"https://doi.org/10.1177/02184923221138505","url":null,"abstract":"<p><strong>Introduction: </strong>An abdominal aortic aneurysm (AAA) is a life-threatening abnormal dilation of the abdominal aorta that can be repaired either endovascularly or with open surgery. However, endovascular aortic repair (EVAR) has become the main treatment modality for AAA due to its more optimal results. EVAR devices can either be standard, fenestrated, or branched, with fenestrated EVAR (FEVAR) seemingly achieving superior prospects. Although EVAR is associated with excellent outcomes, it still carries a risk of certain complications requiring reintervention or 'rescue'. Several commercial EVAR devices are available on the global market, nevertheless, the Fenestrated Anaconda developed by Terumo Aortic can be considered the superior device due to the wide range of endovascular solutions that it offers along with its unique custom-made approach, excellent results and its highly promising potential to be used as a 'rescue' device for failed competitor endografts.</p><p><strong>Materials and methods: </strong>The current study represents a 9-year cross-sectional international analysis of a custom-made Fenestrated Anaconda™ device. For the statistical analysis, SPSS 28 for Windows and R were utilised. Pearson Chi-square analysis was used to assess differences in cumulative distribution frequencies between select variables. Statistical significance for all two-tailed tests was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Out of 5058 EVARs performed using the Fenestrated Anaconda, 2987 (59%) were 'rescue' procedures for migrated Gore (<i>n</i> = 252) and Medtronic (<i>n</i> = 2735) devices. The Fenestrated Anaconda™ was indicated as the reintervention device either due to unsuitable/complex anatomy for the competitor (<i>n</i> = 2411) or based on surgeon preference (<i>n</i> = 576). Overall, the Fenestrated Anaconda was utilised to rescue 3466 (68.5%) failed previous EVARs using competitor devices. Yet, the primary endovascular solution offered by the Fenestrated Anaconda was FEVAR (91.3%), with 112 (2.2%) devices using custom-made iliac stents.</p><p><strong>Discussion: </strong>The use of the Fenestrated Anaconda endograft as a 'rescue' device to salvage failed competitor devices is well-established in the literature with excellent clinical outcomes achieved. The evidence in the literature also highlights the distinctive custom-made approach that the Fenestrated Anaconda offers which enables it to treat extremely complex aortic anatomy.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"31 7","pages":"582-588"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}