Penn Heart and Vascular

Quality and Outcomes at the Complex Aortic Disease Program

Quality & Outcomes

Penn cardiac and vascular surgeons are renowned for their expertise in device-specific endovascular stent procedures, having performed more than 600 of these surgeries since 1999. Penn's outcomes rank among the best in the nation.

Penn is also among a handful of programs in the U.S. educating and training surgeons in an FDA-mandated curriculum to perform device-specific endovascular stent procedures for thoracic aortic aneurysms.

Stent Disease Treatment FY 2010, N = 73

Non-Dissection
Stent Disease Treatment Number Percentage
Traumatic Transections 3 4.1
Ascending Aneurysms 1 1.4
Aneurysm Rupture 12 16.4
Descending Thoracic Aneurysm 24 32.9
Arch Aneurysms (Hybrid) 3 4.1
Dissection
Acute Type B Dissections 9 12.3
Chronic Type B Dissections 15 20.5
Chronic Type A Dissections 1 1.4
Acute Type A Dissections (Hybrids) Elephant Trunk 5 6.8

Non-dissection

  • Traumatic Transections [N=3]
  • Ascending Aneurysms [N=1]
  • Aneurysm Rupture [N=12]
  • Descending Thoracic Aneurysm [N=24]

Dissection

  • Acute Type B Dissections [N=9]
  • Chronic Type B Dissections [N=15]
  • Chronic Type A Dissections [N=1]
  • Acute Type A Dissections (Hybrids) Elephant Trunk [N=5]

Aortic Remodeling

Penn is a world leader in the concept of aortic remodeling. Penn surgeons have been performing procedures designed to "remodel" the downstream aorta in acute aortic dissections (Type A and Type B). The concept of aortic remodeling involves the use of thoracic endografts to seal intimal tear sites between the true and false lumen in acute dissections.

Aortic Remodeling for Acute Type A Dissection

Penn surgeons have designed an operation for repair of Acute Type A Dissection which address the potential, serious late problems in the "downstream" descending dissected aorta by placing an adjunctive TEVAR distally.

Thoracic Endovascular Aortic Repair for Type B Dissection

Thoracic endovascular aortic repair (TEVAR) is among the procedures being advanced at Penn for the treatment of aneurysms of the descending thoracic aorta (Type B). During TEVAR, an endovascular stent graft is placed into the thoracic aorta from a remote peripheral location using imaging guidance. Because TEVAR is less invasive than traditional thoracotomy, the procedure has become an accepted alternative to open surgical repair for thoracic aortic aneurysms.

Reconsidering the Classic Hybrid Total Aortic Arch Repair

Penn surgeons have developed new techniques and technologies to address the high morbidity and mortality that may be associated with classic hybrid total aortic arch repair. Surgical risks include perioperative neurologic complications, particularly in the presence of large atherosclerotic saccular aortic arch aneurysms, which denote extensive arch and brachiocephalic atheromatous disease.

Penn Heart & Vascular Clinical Activity Reports

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