[Multiple surgical treatment of complex aortic arch and descending aorta disease].

Abstract

OBJECTIVE:

To investigate the methods and effectiveness of multiple surgical treatment for complex aortic arch and descending aorta disease, including cardiopulmonary bypass operation, hybrid operation, and total endovascular aneurysm repair (EVAR).

METHODS:

Between October 2006 and September 2011, 48 patients with complex aortic arch and descending aorta disease were treated. There were 31 males and 17 females, aged from 28 to 81 years (mean, 52.4 years). The disease duration ranged from 1 to 90 days (mean, 10.2 days). There were 30 cases of type B aortic dissection involving the aortic arch, 11 cases of thoracic aortic aneurysm, 3 cases of thoracic pseudoaneurysme, 3 cases of penetrating aortic ulcer, and 1 case of aortoesophageal fistula. Cardiopulmonary bypass operation, hybrid operation, and total EVAR were performed in 15, 12, and 21 cases, respectively.

RESULTS:

In the patients undergoing cardiopulmonary bypass operation, the following complications occurred: 1 case of bleeding, 1 case of coma, 3 cases of psychiatric disorders, 4 cases of pneumonia, 2 cases of acute renal insufficiency, and 2 cases of multi-organ dysfunction; finally 3 patients died. In the patients undergoing hybrid operation, cerebral infarction and renal function failure occurred in 1 case. In the patients undergoing total EVAR, no complication occurred. A total of 41 patients were followed up 2 to 60 months (mean, 28.6 months). Slight left subclavian steal syndrome occurred in 3 cases, but self relieved. Other patients recovered to normal life.

CONCLUSION:

In the surgical treatments of complex aortic arch and descending aorta disease, cardiopulmonary bypass operation will be gradually replaced by EVAR because of the surgical trauma and risk, hybrid operation is an important technique, and total EVAR will be the future progress.

• Authors: Hanfan Qiu, Daozhong Chen, Liangwan Chen, Feng Lin, Hua Cao
• Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery (Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi) Vol. 26 Issue 6 Pg. 717-20 (Jun 2012) ISSN: 1002-1892 [Print] China
• PMID: 22792771 (Publication Type: English Abstract, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Aortic Dissection (surgery)
• Aorta, Thoracic (surgery)
• Aortic Aneurysm, Thoracic (surgery)
• Blood Vessel Prosthesis Implantation
• Cardiopulmonary Bypass
• Endovascular Procedures
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Stents
• Subclavian Artery (surgery)
• Treatment Outcome
• Vascular Surgical Procedures (methods)