Document Detail


Open surgical repair of 2286 thoracoabdominal aortic aneurysms.
MedLine Citation:
PMID:  17257942     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: As endovascular approaches to thoracoabdominal aortic repairs continue to evolve, careful assessment of the safety and efficacy of these alternative approaches will require comparison with standard open surgical repair. The purpose of this report is to update our experience with conventional open repair of thoracoabdominal aortic aneurysms. METHODS: Since 1986, 2286 patients have undergone open repair of thoracoabdominal aortic aneurysms on our service. Of these, 1662 patients (72.7%) had degenerative aneurysms without dissection, 78 (3.4%) had acute aortic dissection, and 546 (23.9%) had chronic dissection. There were 139 ruptured aneurysms (6.1%). Extensive repairs (ie, Crawford extents I and II) were performed in 1468 patients (64.2%). Segmental intercostal or lumbar arteries were reattached in 1401 patients (61.3%), left heart bypass was used in 909 (39.8%), and cerebrospinal fluid drainage was used in 615 (26.9%). RESULTS: The 30-day survival rate was 95.0% (2171 patients). Renal failure requiring hemodialysis occurred in 129 patients (5.6%), and paraplegia or paraparesis developed in 87 patients (3.8%). Patients who underwent replacement of the entire thoracoabdominal aorta (extent II) had the highest rates of death (6.0%), spinal cord deficit (6.3%), and renal failure (8.3%). CONCLUSIONS: Current management strategies enable patients to undergo conventional open thoracoabdominal aortic aneurysm repair with excellent early survival and acceptable morbidity.
Authors:
Joseph S Coselli; John Bozinovski; Scott A LeMaire
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S862-4; discussion S890-2     Citation Subset:  AIM; IM    
Affiliation:
The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting / surgery
Aortic Aneurysm, Abdominal / surgery*
Aortic Aneurysm, Thoracic / surgery*
Aortic Rupture / surgery
Blood Vessel Prosthesis Implantation / adverse effects,  mortality
Databases, Factual
Humans
Kidney Failure / etiology,  therapy
Middle Aged
Paraparesis / etiology
Paraplegia / etiology
Renal Dialysis
Retrospective Studies
Spinal Cord Diseases / etiology
Survival Analysis
Vascular Surgical Procedures* / adverse effects,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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