Outcomes After Visceral Aortic Coral Reef Surgery

Study Overview
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Brief Summary
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Coral reef aorta is defined by a calcified stenosis of the visceral aorta which can cause leg claudication, renal failure and visceral ischemia depending the type and localisation of the stenosis. This pathology is rare and is usually treated by open surgery with aortic endarteriectomy. Little is know about the outcomes after such aggressive surgery with short series and short follow up. The authors propose a retrospective study from their institution to explore the post operative and long term outcomes after this surgery.

Detailed Description
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Coral reef aorta is defined by a calcified stenosis of the visceral aorta which can cause leg claudication, renal failure and visceral ischemia depending the type and localisation of the stenosis. This pathology is rare and is usually treated by open surgery with aortic endarteriectomy. Little is known in the literature regarding the outcomes of this aggressive surgery. The authors propose a retrospective study from their institution describing the type of surgery realised. They describe the post operative outcomes of this surgery in term of cardiologic, respiratory, renal complication a,d surgical complication. Moreover they follow the patients to present long term outcomes of this pathology with a description of the post operative recurrence of a coral reef, the permeability of the different target vessel and the cardiologic, respiratory and renal evolution of the different patients.

Official Title
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Long Term Outcomes After Visceral Aortic Endarteriectomy for Coral Reef Lesion

Conditions
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Aortic Coral Reef

Intervention / Treatment
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* Procedure: Aortic endarteriectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Coral reef surgery Urgent intervention Claudication, renal, visceral involvement Thoracic aortic cross clamping (above coeliac trunk) Exclusion Criteria: simple visceral aorto thrombectomy without opening laterally the aorta Pregnant
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Aortic endarteriectomy|Thoraco-phreno-lumbotomy with thoracic aortic cross clamping Longitudinal aortotomy Endarteriectomy of the aorta Direct closure more or less bypass to the visceral arteries and downstream aorta reconstruction.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major adverse cardiac event (MACE) | Post operative cardiologic complication | 1 month after surgery | 
| Reintervention | Need of reintervention before discharge | 1 month after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Long term follow up | Cumulative survival rate | 1 month, 1 year, yearly up to 5 years | 
| Target vessel patency | Permeability of the different vessel (renal and visceral arteries) on CT scan or Duplex ultrasound | 1 month, 1 year, yearly up to 5 years | 
| Kidney function evolution | glomerular filtration rate evolution, | 1 month, 1 year, yearly up to 5 years |