Cirugía Abierta Versus Cirugía Endovascular en el Tratamiento de la Patología de la Aorta Torácica Descendente

Abstract

Thoracic Endovascular Aortic Repair (TEVAR) has increased worldwide more than open repair in the last few years. The results are still controversial. In Colombia, there is not enough information. Objective: compare clinical outcomes of TEVAR versus open surgery at Fundación Cardioinfantil (Bogotá, Colombia), between 2002 and 2011 Methods: Retrospective analysis of the cohort of patients with open repair (group 1) in comparison to TEVAR (group 2). In each group, surgical time, mor-bidity rates (infection, hemorrhage, medular ischemia, cerebrovascular event and postoperative renal failure), mortality, reintervention and hospital stay were evaluated. For comparisons a univariate analysis was used, being a p<0.05 statistically significant. Results: 57 patients were included (26% open repair,74% TEVAR). Two type 1 endoleaks on group 2 and 1 bleeding patient in group 1 required a second surgery. Surgical mortality was (group 1: 20%; group 2: 2.3%); surgical time was 398 ± 180 (group 1) versus 85,5 ± 35 min (group 2) (p=0.0001); and hospital stay was 9,8 days (group 1) and 5,3 days (group 2) Average follow-up time was 4,8± 3,1 years. Conclusions: TEVAR may be associated with less morbidity, mortality, surgical time, and hospital stay than open repair, although the populations included were not strictly comparable. New, prospective studies, ideally randomized, are needed to support the long term benefits of this type of repair.