Ann Thorac Surg 2006;82:565-566
© 2006 The Society of Thoracic Surgeons
Original article: Cardiovascular
Invited commentary
Enio Buffolo, MD, PhD
São Paulo Federal University, R. Borges Lagoa, 1080-cj. 701, São Paulo SP, 04038-002 Brazil
(Email: enio.buffolo{at}terra.com.br).
The article by Kaya and associates [1] calls attention to the possibility of treating acute aortic syndromes by endovascular stenting.
This policy may have strong impact in mortality and morbidity rates that are usually very high in these conditions considering a conventional surgical approach.
Hospital mortality of 21.4% (6 of 28) was due to severely compromised clinical status preoperatively, and it seems fair to assume that conventional surgery would have much higher risk or would not be considered.
It is important to observe that even by covering the entire descending aorta with more than one stent the authors did not observe paraplegia or paraparesia. It is also our experience that the incidence of neurologic deficit is rare with descending thoracic aorta stenting even in acute situations.
If the authors separated traumatic aortic rupture and ruptured thoracic aneurysm, the results for intramural hematoma, type B dissecting aneurysms, and penetrating ulcer, then the results would probably be much better.
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References
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- Kaya A, Heijmen RH, Overtoom TTh, Vos J-A, Morshuis WJ, Schepens MA. Thoracic stent grafting for acute aortic pathology Ann Thorac Surg 2006;82:560-566.[Abstract/Free Full Text]
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