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Reflection of pioneers: redo thoracoabdominal aortic aneurysm repair controversies in thoracic aortic aneurysm surgery

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  • Controversies in Surgery for Thoracic Aorta
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Abstract

Reoperative thoracoabdominal aortic aneurysm repair is frequently necessary and brings with it a unique set of challenges. Typically, most reoperative repairs are necessitated by aortic disease progressing into previously healthy aortic tissue from a replaced section of the aorta (an extension of the previous repair) or, to a lesser degree, because of a late complication of prior distal aortic repair (an open or endovascular repair failure). Characterizing the reason for the reoperation as well as the location of prior repair is the first step towards anticipating major outcomes following such repair. Since the introduction of endovascular repair for aortic aneurysms, indications for open repair have become more specific and limited; many centers have justified using endovascular approaches in patients with prior open aortic repair by deeming these patients “high risk” because of their previous incision. Our analysis found that reoperative repairs were not typically subject to worse early outcomes than patients without prior distal aortic repair, except for the more complicated types of reoperation, which involve infection.

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Acknowledgements

Dr. Coselli thanks Susan Y. Green, MPH, and Hiruni S. Amarasekara, MS, for editorial support, and Scott A. Weldon, MA, CMI, and Nathan Gray, BFA for creating the illustrations.

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Authors and Affiliations

  1. Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, Houston, TX, 77030, USA

    Joseph S. Coselli

  2. Section of Adult Cardiac Surgery, Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX, USA

    Joseph S. Coselli

  3. CHI St. Luke’s Health-Baylor St. Luke’s Medical Center, Houston, TX, USA

    Joseph S. Coselli

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  1. Joseph S. Coselli
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Correspondence to Joseph S. Coselli.

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Coselli, J.S. Reflection of pioneers: redo thoracoabdominal aortic aneurysm repair controversies in thoracic aortic aneurysm surgery. Gen Thorac Cardiovasc Surg 67, 168–174 (2019). https://doi.org/10.1007/s11748-018-0978-y

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  • DOI: https://doi.org/10.1007/s11748-018-0978-y

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