Document Detail


Surgical treatment of pseudoaneurysm of the thoracic aorta.
MedLine Citation:
PMID:  16872966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To examine the clinical profiles, operative outcomes, and late results of patients with pseudoaneurysm of the thoracic aorta. METHODS: From 1990 to 2002, 60 patients underwent repair of aortic pseudoaneurysm: ascending aorta in 70%, ascending aorta and arch in 15%, descending aorta in 10%, and arch alone in 5%. Mean age was 53 +/- 15 years, and 70% were men. Of these, 50 (83%) had undergone previous cardiac surgery, including 22 (37%) composite valve graft operations. The preferred cannulation site was femoral-femoral (n = 27, 45%), with deep hypothermic circulatory arrest in 62% and retrograde cerebral perfusion in 33%; more recently, however, axillary cannulation has been preferred. RESULTS: Principal etiologies were graft infection in ascending aorta pseudoaneurysm and trauma in descending aorta pseudoaneurysm. Fifteen patients (25%) presented with chest pain, 13 (22%) with heart failure, and 20% with moderate or severe aortic regurgitation. The pseudoaneurysm was resected and the aorta replaced (n = 45, 75%) or repaired (n = 15, 25%) using various methods. Hospital mortality was 6.7% (n = 4). Reexploration for bleeding was required in 8.3%, and 3.3% had postoperative stroke. At 30 days, 5 years, and 10 years, survival was 94%, 74%, and 60% and freedom from reoperation was 95%, 77%, and 67%, respectively. CONCLUSIONS: Most patients with aortic pseudoaneurysm require ascending aorta and/or arch replacement, which can be accomplished with low operative mortality and morbidity. Long-term survival and freedom from reoperation in these young patients parallel those expected for complex cardiac and aortic disease.
Authors:
Fernando A Atik; Jose L Navia; Lars G Svensson; Pablo Ruda Vega; Jingyuan Feng; Mariano E Brizzio; A Marc Gillinov; B Gosta Pettersson; Eugene H Blackstone; Bruce W Lytle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  132     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-28     Completed Date:  2006-09-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  379-85     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, False / etiology,  mortality,  surgery*
Aortic Aneurysm, Thoracic / etiology,  mortality,  surgery*
Blood Vessel Prosthesis Implantation
Female
Hospital Mortality
Humans
Male
Middle Aged
Reoperation
Stroke / epidemiology
Treatment Outcome

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


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