Retrospective single-center study evaluating short- and long-term outcomes of open thoracoabdominal aortic repair (extent I–V) in 56 patients with connective tissue disease (primarily Marfan syndrome and Loeys-Dietz syndrome) between 2013 and 2025; primary outcomes were 30-day and 1-year mortality.
30-day mortality was 2% (n=1) and 1-year mortality was 5% (n=3); spinal cord ischemia occurred in only 1 patient (2%); intercostal patch aneurysms developed in 15% (n=8), requiring endovascular repair in 5; overall survival at mean 68-month follow-up was 89%, with branch-graft primary patency ≥94% across all visceral/renal vessels.
Single-center retrospective design with a relatively small cohort (n=56); results may not generalize beyond high-volume specialized centers; long follow-up had wide standard deviations (±47–48 months), suggesting heterogeneous surveillance duration.
Open thoracoabdominal aortic repair is safe and durable for CTD patients at experienced centers, but clinicians must maintain lifelong imaging surveillance—intercostal patch aneurysms arose in 1 in 7 patients and often required endovascular reintervention.
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