Endovascular stent-graft repair of late XXXX after surgery for @entity1498 .

@entity1 @entity548 @entity1514 @entity1498 @entity397 @entity439 @entity2849
BACKGROUND: We analyzed the potential of endovascular stent grafts to treat late @entity2849 after @entity1498 repair. METHODS: Eight @entity1 (7 male; age 28 to 58, mean 43 years) presented with @entity2849 after primary repair performed at the age of 5 to 27 (mean 12) years; 2 @entity1 had @entity397 with @entity548 . The mean interval between the procedures was 31 (19 to 42) years; one @entity1 had 3 previous operations. This subset represents 2.2% of our overall experience in @entity1514 repair (n=368). @entity1514 endografts were implanted using the transfemoral technique. Custom-made reverse tapered stent grafts were used in 4 cases. The left subclavian artery (LSA) was covered in 5 @entity1 . Protective transposition of the left subclavian artery was performed in 4 @entity1 . RESULTS: Hospital mortality was 12.5%; 1 @entity1 died from secondary @entity397 after emergency repair. Primary complete exclusion of the @entity439 was achieved in 6 @entity1 . Secondary exclusion after implantation of a second stent graft was successful in the second @entity397 @entity1 . No endoleak was present at discharge. All discharged @entity1 are alive after 8 to 63 (mean 36) months. Follow-up computed tomography or transesophageal echocardiography revealed no secondary endoleaks or late expansion. The @entity2849 had shrunk completely in 3 @entity1 , were reduced in size in 2 @entity1 , and remained unchanged in 2 @entity1 . No late secondary interventions were noted. CONCLUSIONS: Single piece, reversed, tapered stent grafts adapt better to the special anatomy of the hypoplastic aortic arch. Midterm results are excellent; complete shrinkage in 50% is remarkable. However, the long-term behavior of these implants in young @entity1 requires further evaluation and surveillance.
