BACKGROUND: Extensive surgical resection of the thoracic aorta in patients with type A aortic dissection (TAAD) is thought to reduce the risk of late aortic wall degeneration and the need for repeat aortic operations. OBJECTIVES: We evaluated the early and late outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root. DESIGN: Retrospective, multicenter cohort study. METHODS: The outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root, that is dissection flap located at least in one of the Valsava segments, were herein evaluated. In-hospital mortality, neurological complications, dialysis as well as 10-year repeat proximal aortic operation, and mortality were the outcomes of this study. RESULTS: Supracoronary ascending aortic replacement was performed in 198 patients and aortic root replacement in 215 patients. During a mean follow-up of 4.0 ± 4.0 years, 19 patients underwent 22 repeat procedures on the aortic root and/or aortic valve. No operative death occurred after these reinterventions. The risk of proximal aortic reoperation was significantly lower in patients who underwent aortic root replacement (5.5% vs 12.9%, adjusted subdistributional hazard ratio (SHR) 0.085, 95% CI 0.022-0.329). Aortic root replacement was associated with higher rates of in-hospital (14.4% vs 12.1%, adjusted odds ratio 2.192, 95% CI 1.000-4.807) and 10-year mortality (44.5% vs 30.4%, adjusted hazard ratio 2.216, 95% CI 1.338-3.671). Postoperative neurological complications and dialysis rates were comparable in the study groups. CONCLUSION: Among patients with TAAD involving the aortic root, its replacement was associated with a significantly lower rate of repeat proximal aortic operation of any type compared to supracoronary aortic replacement. Still, aortic root replacement seems to be associated with an increased risk of mortality in these patients. UNLABELLED: ClinicalTrials.gov: NCT04831073 (https://clinicaltrials.gov/study/NCT04831073).

• MeSH
• aneurysma hrudní aorty * chirurgie   mortalita   diagnostické zobrazování   MeSH
• časové faktory MeSH
• cévy - implantace protéz * škodlivé účinky   mortalita   MeSH
• disekce aorty * chirurgie   mortalita   MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích * MeSH
• pooperační komplikace * epidemiologie   etiologie   mortalita   MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH

BACKGROUND: Acute Stanford type A aortic dissection is a severe emergency condition that, if left untreated, is associated with a high mortality rate. The extent of surgical repair may impact the outcomes of these patients. METHOD: Patients operated for acute type A aortic dissection from a multicentre European registry were included. Patients were categorized based on the following types of surgical intervention: isolated ascending aortic replacement, ascending aortic replacement with concomitant aortic valve replacement, aortic root replacement, partial or total arch replacement, and partial or total arch replacement with concomitant aortic root replacement. The primary outcome was mortality rate, both in-hospital and at 10 years. Secondary outcomes were acute kidney injury requiring dialysis, neurological complications, a composite endpoint including in-hospital death, neurological complications and/or dialysis, and proximal endovascular or surgical aortic re-operations at 10 years. RESULTS: 3702 patients were included. The adjusted risk of in-hospital mortality was higher in all subsets of patients compared to those who underwent isolated ascending aortic replacement. The adjusted rates of in-hospital mortality ranged from 16.4% (95% c.i. 15.3 to 17.4) among patients who underwent isolated ascending aortic replacement to 27.7% (95% c.i. 23.3 to 31.2) among those who underwent aortic arch and concomitant aortic root replacement. The adjusted risks of neurological complications, renal replacement therapy and of the composite endpoint were significantly higher in patients who underwent partial/total aortic arch replacement. The adjusted risk estimates of 10-year mortality rate were markedly higher in patients who underwent partial/total aortic arch replacement with or without concomitant aortic root replacement. Extensive aortic repair did not significantly reduce the risk of distal or proximal aortic reoperations. CONCLUSION: These findings suggest that, when feasible, limiting the extent of aortic replacement for acute type A aortic dissection may be beneficial in reducing mortality rate and major complications both in the short and long term. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04831073.

• MeSH
• aortální aneurysma chirurgie   mortalita   MeSH
• cévy - implantace protéz * škodlivé účinky   mortalita   metody   MeSH
• disekce aorty * chirurgie   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích * MeSH
• pooperační komplikace * epidemiologie   mortalita   etiologie   MeSH
• registrace * MeSH
• reoperace statistika a číselné údaje   MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

INTRODUCTION: Thoracic aorta false aneurysms (TAFA) are unexplored complications after cardiac surgery associated with significant morbidity and mortality. Therefore, the purpose of this study was to examine the clinical profiles, surgical techniques, and operative outcomes, of patients treated for TAFA at a single institution. METHODS: From 1996 to 2022, 112 patients were treated for aortic pseudoaneurysm (mean age 55 ± 14 years, 78 patients were male). In the majority of the patients (90%) TAFA developed after previous cardiovascular surgery, the most common diagnosis and surgical procedure preceding the TAFA development was an aortic dissection (52%) and Bentall procedure (47%). In the rest of the cohort, the leading cause was trauma. RESULTS: Sixty-one percent of patients were indicated for reintervention (surgical reoperation, endoluminal graft implantation, septal occluder implantation, coil embolization, or a combination of procedures). Overall, 52 patients had undergone cardiac reoperation. TAFA was resected and the aorta was repaired in 55% or replaced in 45%. Operative mortality was 5.7%. In postoperative follow-up, a hypoechogenic lesion encircling aortic prosthesis was present in 94%, therefore it was determined as a negative prognostic factor. The mean follow-up was 13.2 ± 19.4 years. CONCLUSION: Although there is no specific approach how to prevent TAFA development, maintaining normal blood pressure and regular follow-up should be applied. More frequent follow-ups should be performed in patients with a hypoechogenic lesion encircling and aortic prosthesis. Early detection during long-term postoperative follow-up, an individually tailored approach of a multidisciplinary team is necessary for favorable treatment outcomes.

• MeSH
• aneurysma hrudní aorty * chirurgie   MeSH
• aorta thoracica chirurgie   diagnostické zobrazování   MeSH
• časové faktory MeSH
• cévy - implantace protéz škodlivé účinky   MeSH
• dospělí MeSH
• endovaskulární výkony škodlivé účinky   MeSH
• kombinovaná terapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• nepravé aneurysma * chirurgie   etiologie   diagnostické zobrazování   terapie   MeSH
• pooperační komplikace etiologie   chirurgie   MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Extended aortic repair is considered a key issue for the long-term durability of surgery for DeBakey type 1 aortic dissection. The risk of aortic degeneration may be higher in young patients due to their long life expectancy. The early outcome and durability of aortic surgery in these patients were investigated in the present study. METHODS: The subjects of the present analysis were patients under 60 years old who underwent surgical repair for acute DeBakey type 1 aortic dissection at 18 cardiac surgery centres across Europe between 2005 and 2021. Patients underwent ascending aortic repair or total aortic arch repair using the conventional technique or the frozen elephant trunk technique. The primary outcome was 5-year cumulative incidence of reoperation on the distal aorta. RESULTS: Overall, 915 patients underwent surgical ascending aortic repair and 284 patients underwent surgical total aortic arch repair. The frozen elephant trunk procedure was performed in 128 patients. Among 245 propensity score-matched pairs, total aortic arch repair did not decrease the rate of distal aortic reoperation compared to ascending aortic repair (5-year cumulative incidence, 6.7% versus 6.7%, subdistributional hazard ratio 1.127, 95% c.i. 0.523 to 2.427). Total aortic arch repair increased the incidence of postoperative stroke/global brain ischaemia (25.7% versus 18.4%, P = 0.050) and dialysis (19.6% versus 12.7%, P = 0.003). Five-year mortality was comparable after ascending aortic repair and total aortic arch repair (22.8% versus 27.3%, P = 0.172). CONCLUSIONS: In patients under 60 years old with DeBakey type 1 aortic dissection, total aortic arch replacement compared with ascending aortic repair did not reduce the incidence of distal aortic operations at 5 years. When feasible, ascending aortic repair for DeBakey type 1 aortic dissection is associated with satisfactory early and mid-term outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073.

• MeSH
• aneurysma hrudní aorty chirurgie   mortalita   MeSH
• aorta thoracica * chirurgie   MeSH
• cévy - implantace protéz * metody   škodlivé účinky   mortalita   MeSH
• disekce aorty * chirurgie   mortalita   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• pooperační komplikace * epidemiologie   MeSH
• reoperace * statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• tendenční skóre MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Surgery for Stanford type A aortic dissection (TAAD) is associated with an increased risk of late aortic reoperations due to degeneration of the dissected aorta. METHODS: The subjects of this analysis were 990 TAAD patients who survived surgery for acute TAAD and had complete data on the diameter and dissection status of all aortic segments. RESULTS: After a mean follow-up of 4.2 ± 3.6 years, 60 patients underwent 85 distal aortic reoperations. Ten-year cumulative incidence of distal aortic reoperation was 9.6%. Multivariable competing risk analysis showed that the maximum preoperative diameter of the abdominal aorta (SHR 1.041, 95%CI 1.008-1.075), abdominal aorta dissection (SHR 2.133, 95%CI 1.156-3.937) and genetic syndromes (SHR 2.840, 95%CI 1.001-8.060) were independent predictors of distal aortic reoperation. Patients with a maximum diameter of the abdominal aorta >30 mm and/or abdominal aortic dissection had a cumulative incidence of 10-year distal aortic reoperation of 12.0% compared to 5.7% in those without these risk factors (adjusted SHR 2.076, 95%CI 1.062-4.060). CONCLUSION: TAAD patients with genetic syndromes, and increased size and dissection of the abdominal aorta have an increased the risk of distal aortic reoperations. A policy of extensive surgical or hybrid primary aortic repair, completion endovascular procedures for aortic remodeling and tight surveillance may be justified in these patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073.

• MeSH
• aneurysma hrudní aorty * chirurgie   MeSH
• aorta abdominalis diagnostické zobrazování   chirurgie   MeSH
• aortální aneurysma * chirurgie   MeSH
• azidy * MeSH
• cévy - implantace protéz * škodlivé účinky   MeSH
• deoxyglukosa analogy a deriváty   MeSH
• disekce aorty * diagnostické zobrazování   chirurgie   MeSH
• lidé MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD). SUMMARY BACKGROUND DATA: The optimal extent of aortic resection during surgery for acute TAAD is controversial. METHODS: This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals. RESULTS: Out of 3902 consecutive patients, 689 (17.7%) died during the index hospitalization. Among 2855 patients who survived 3 months after surgery, 10-year observed survival was 65.3%, while country-adjusted, age-adjusted, and sex-adjusted expected survival was 81.3%, yielding a relative survival of 80.4%. Among 558 propensity score-matched pairs, total aortic arch replacement increased the risk of in-hospital (21.0% vs. 14.9%, P =0.008) and 10-year mortality (47.1% vs. 40.1%, P =0.001), without decreasing the incidence of distal aortic reoperation (10-year: 8.9% vs. 7.4%, P =0.690) compared with ascending aortic replacement. Among 933 propensity score-matched pairs, in-hospital mortality (18.5% vs. 18.0%, P =0.765), late mortality (at 10-year: 44.6% vs. 41.9%, P =0.824), and cumulative incidence of proximal aortic reoperation (at 10-year: 4.4% vs. 5.9%, P =0.190) after aortic root replacement was comparable to supracoronary aortic replacement. CONCLUSIONS: Replacement of the aortic root and aortic arch did not decrease the risk of aortic reoperation in patients with TAAD and should be performed only in the presence of local aortic injury or aneurysm. The relative survival of TAAD patients is poor and suggests that the causes underlying aortic dissection may also impact late mortality despite surgical repair of the dissected aorta.

• MeSH
• aneurysma hrudní aorty * chirurgie   MeSH
• aortální aneurysma * chirurgie   MeSH
• cévy - implantace protéz * škodlivé účinky   MeSH
• disekce aorty * chirurgie   MeSH
• lidé MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

U pacientů s akutní disekcí aorty typu B (dle Stanfordské klasifikace) s komplikovaným průběhem je rekonstrukce hrudní aorty endovaskulárním přístupem (thoracic endovascular aortic repair, TEVAR) léčbou první volby. Smyslem implantace stentgraftu je překrytí entry disekce provázené v ideálním případě následnou trombotizací falešného lumen v průběhu celého stentgraftu, čímž dochází ke stabilizaci stěny hrudní aorty. V námi popisované kazuistice k této žádoucí trombotizaci nedošlo. Důvodem byl zachovaný průtok falešným lumen při nediagnostikované perzistující Botallově dučeji. Řešením této komplikace bylo uzavření perzistujícího zkratu pomocí Amplatzerova síňového okluderu cestou falešného lumen disekované aorty.

In patients diagnosed with an acute aortic dissection type B according to the Stanford classification, thoracic endovascular repair (TEVAR) is the primary recommended treatment in cases with a complicated course. The purpose of implanting a stent graft is to close the entry point of the dissection, thus hopefully causing a thrombus to fill the false lumen throughout the whole stent graft, stabilizing the thoracic aortic wall. In our case report, the thrombus unfortunately did not form, the reason being continuous flow through the false lumen due to an undiagnosed persisting Botallo's duct. The solution to this complication was closing the persisting shunt by implanting an Amplatzer septal occluder through the false lumen of the dissected aorta.

• MeSH
• aortální aneurysma diagnostické zobrazování   MeSH
• bolesti na hrudi etiologie   MeSH
• cévy - implantace protéz metody   škodlivé účinky   MeSH
• CT angiografie MeSH
• disekce hrudní aorty * chirurgie   diagnostické zobrazování   patologie   MeSH
• ductus arteriosus * chirurgie   diagnostické zobrazování   patologie   MeSH
• endoleak klasifikace   terapie   MeSH
• endovaskulární výkony metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neúspěšná terapie MeSH
• otevřená tepenná dučej terapie   MeSH
• srdeční arytmie diagnóza   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• kazuistiky MeSH

OBJECTIVES: The treatment of concomitant abdominal aortic aneurysms and renal tumours is controversial. The aim of this study was to ascertain which of the following three strategies, one-stage open aneurysm repair and nephrectomy, two-stage open aneurysm repair and nephrectomy or two-stage endovascular aneurysm repair and nephrectomy, is the best approach. METHODS: systematic review and meta-analysis of articles published between January 1992 and April 2021 describing the treatment of concomitant abdominal aortic aneurysms and renal tumours. RESULTS: A total of 1168 records were identified. After the selection process, 12 studies with data on 89 patients were included. Sixty-two patients underwent one-stage open procedures, 18 patients underwent two-stage open procedures and nine underwent two-stage endovascular procedures. The overall postoperative mortality was 0.82% (95% CI, 0.00-4.61). The postoperative mortality for one-stage open procedures was 3.09% (95% CI, 0.00-10.11). No deaths occurred in the postoperative period open two-stage procedures or two-stage endovascular procedures. The weighted postoperative morbidity for all procedures was 23.86% (95% CI, 12.64-35.08) and for open one-stage procedures was 37.40% (95% CI, 14.33-60.47). Data concerning postoperative complications of two-stage open procedures were extractable from only one patient in whom no complications were reported. Two postoperative complications were reported after two-stage endovascular procedures from a total of six patients with extractable postoperative data. We were unable to perform meta-analysis on long-term outcomes as the data were reported non-uniformly. CONCLUSION: There is currently no evidence to suggest that any procedure is associated with better outcomes. However, a one-stage open approach was the most commonly used option, favoured as it avoids delaying treatment of either of the conditions. Two-stage open procedures were preferred in cases where the surgical risk of a one-stage procedure was higher than the potential benefit. For such cases, two-stage endovascular repair is becoming more popular as a less invasive approach.

• MeSH
• aneurysma břišní aorty * komplikace   diagnostické zobrazování   chirurgie   MeSH
• cévy - implantace protéz * škodlivé účinky   MeSH
• endovaskulární výkony * MeSH
• lidé MeSH
• nádory ledvin * komplikace   diagnostické zobrazování   chirurgie   MeSH
• pooperační komplikace MeSH
• rizikové faktory MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

Úvod: Infekce cévních protéz v aortoilické oblasti (abdominální VGI) je jednou z nejzávažnějších komplikací v cévní chirurgii. Řešení je zatíženo vysokou mírou mortality a morbidity. V 2020 vydala the European Society for Vascular Surgery (ESVS) doporučení pro diagnostiku a terapii infekcí vaskulárních graftů a endograftů. I ve světle těchto doporučení jsme se rozhodli retrospektivně prozkoumat pacienty s abdominální VGI, které jsme řešili na našem pracovišti. Metody: Retrospektivní observační studie pacientů s abdominální VGI, kteří byli řešeni na našem pracovišti v období 2011−2019 (za 9 let). Primárním cílem bylo určit procento infekcí cévních chirurgických rekonstrukcí v aortoilické oblasti provedených v období 2011−2019 a zhodnotit mortalitu u pacientů operovaných pro tuto komplikaci. Sekundárním cílem bylo zhodnotit úspěšnost a rizika různých typů výkonů. Výsledky: V uvedeném období jsme provedli 363 chirurgických rekonstrukcí v aortoilické oblasti. Ve stejném období jsme řešili celkem 15 pacientů s abdominální VGI, z nichž byla primární aortální rekonstrukce většinou (11×) provedena před rokem 2011. U našeho souboru rekonstrukcí z let 2011−2019 byla abdominální VGI zaznamenána pouze ve 4 případech, tedy u 1,1 %. V souboru 15 řešených abdominálních VGI převažovali muži (14×). Průměrný věk v době původní rekonstrukce byl 61 let. Většinou šlo o ischemickou chorobu dolních končetin (14×). Vždy šlo o infekci aortobifemorálního (1× aortofemorálního) bypassu. Vždy šlo o pozdní infekci s průměrným intervalem 61 měsíců od původní rekonstrukce (15−180 měsíců). Časná mortalita v tomto souboru byla 27 % (4 pacienti). Celková mortalita byla 40 %. Po primárním řešení infekce jsme zaznamenali 33 % reinfekcí. Závěr: Výsledky řešení infekce graftu v aortoilické oblasti jsou nadále zatíženy vysokou mortalitou a morbiditou. V řešení i diagnostice je užitečné postupovat podle aktuálních doporučení ESVS. Nicméně je zřejmé, že konečné řešení by mělo být individuálně určeno pro každého jednoho pacienta na základě multioborového přístupu.

Introduction: Vascular graft infection in the aortoiliac territory (abdominal VGI) is undoubtedly one of the most serious complications in vascular surgery. The treatment is burdened with high mortality and morbidity rates. In 2020, the Guidelines on the Management of Vascular Graft and Endograft Infections were published by the European Society for Vascular Surgery (ESVS). In the light of these guidelines, we decided to review retrospectively all patients who presented to our institution with abdominal VGI. Methods: Retrospective observational study of patients presented with abdominal VGI treated in our institution between 2011−2019 (9 years). The primary goal was to elucidate the rate of vascular graft infection in aortoiliac reconstructions performed between 2011−2019 and also the mortality rate in the patient cohort operated for this complication. The secondary goals were to evaluate the success rate and the complication rate in different types of reconstructions. Results: In the defined period between 2011−2019 we performed 363 open aortoiliac reconstructions. During the same period we treated altogether 15 patients with abdominal VGI, whose primary reconstruction was mostly performed before 2011 (11 patients). In our cohort of patients who underwent reconstruction between 2011−2019 we observed a graft infection only in 4 cases (1.1%). In the group of 15 patients with abdominal VGI, the male gender prevailed (14 patients). The mean age at the time of primary reconstruction was 61 years. Most of our reconstructions were performed for occlusive disease (14 cases). All infected grafts were aortobifemoral (1 unilateral aortofemoral). They were all late infections with an average presentation time of 61 months since the primary reconstruction (15−180 months). Early mortality rate was as high as 27% (4 patients) and overall mortality was 40%. The secondary reinfection rate after primary treatment was 33%. Conclusion: Treatment of abdominal VGI is still burdened with high mortality and morbidity rates. The current ESVS guidelines provide valuable guidance for the diagnosis and management of VGI. It nevertheless remains obvious that the treatment needs to be tailored individually in a multidisciplinary team environment.

• MeSH
• aorta abdominalis * chirurgie   patologie   MeSH
• cévy - implantace protéz * škodlivé účinky   MeSH
• infekce spojené se zdravotní péčí * diagnóza   mortalita   terapie   MeSH
• lidé MeSH
• pozorovací studie jako téma MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Accumulated endovascular aneurysm repair (EVAR) procedures will increase number of patients requiring conversion to open repair of abdominal aortic aneurysms (AAA). In most cases, patients undergo late open surgical conversion (LOSC), many months, or years, after initial EVAR. The aim of this study is to analyze results of LOSC after EVAR in elective and urgent setting, including presenting features, surgical techniques, as well as to review the clinical outcomes and their predictors. METHODS: Retrospective review of all consecutive patients undergoing LOSC after EVAR was performed at three distinct, high volume, vascular centers. Patients that required primary conversion within 30 days after EVAR have not been included in this study. Between January 1st 2010 and January 1st 2017 total of 31 consecutive patients were treated. LOSC were performed either in elective or in urgent setting, thus dividing patients in two groups. Primary outcome was 30-day mortality and secondary postoperative complications. RESULTS: LOSC rate after EVAR was 4.51%. Most common indication for LOSC was type I endoleak (N.=20, 64.51%). All patients that presented with ruptured AAA had some form of endoleak (type I endoleak was present in five from six cases). Most common site for aortic cross-clamping was infrarenal (51.61%). Stent-graft was removed completely in 18 patients (58.06%) and partially in 13 (41.93%). 30-day mortality rate was 16.12% (5 patients) and most common cause of death was myocardial infarction (60%). Following univariate factors were isolated as predictors for 30-day mortality: preoperative coronary artery disease, chronic obstructive pulmonary disease, urgent LOSC, prolonged time until LOSC, ruptured AAA, supraceliac clamp, higher number of red blood cell transfusion, postoperative myocardial infarction, and prolonged intubation (more than 48 hours). CONCLUSIONS: LOSC seems to be safe and effective procedure when preformed in elective manner. On the other side, urgent LOSC after EVAR is associated with very high postoperative mortality and morbidity. Endoleak remains the main indication for open conversion. Further studies are necessary to standardize timing and treatment options for failing EVAR.

• MeSH
• aneurysma břišní aorty diagnostické zobrazování   mortalita   chirurgie   MeSH
• časové faktory MeSH
• cévy - implantace protéz škodlivé účinky   metody   MeSH
• databáze faktografické MeSH
• endoleak chirurgie   MeSH
• endovaskulární výkony škodlivé účinky   metody   MeSH
• konverze na otevřenou operaci metody   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• mortalita v nemocnicích MeSH
• multivariační analýza MeSH
• prediktivní hodnota testů MeSH
• příčina smrti * MeSH
• prognóza MeSH
• reoperace metody   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• specializovaná centra se zvyšujícím se počtem výkonů a tím zvyšující se kvalitou léčby MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH