Thoracoabdominal aortic aneurysm repair: review and update of current strategies.

Abstract

BACKGROUND:

Surgical repair of thoracoabdominal aortic aneurysms remains a technically challenging operation that requires a multimodality approach to preventing ischemic complications. The purpose of this report is to update our experience and highlight our current clinical strategies.

METHODS:

Between January 1, 1986 and December 31, 2001, 1,773 patients underwent thoracoabdominal aortic aneurysm repair. The majority of these patients (1,153, 65%) required Crawford extent I or II repairs. Segmental intercostal or lumbar arteries were reattached in 1,082 patients (61%); left heart bypass was used in 686 patients (38.7%), and 173 patients (9.8%) had cerebrospinal fluid drainage.

RESULTS:

The 30-day survival rate was 94.3% (1,672 patients). Postoperative complications included renal failure requiring hemodialysis in 105 patients (5.9%) and paraplegia or paraparesis in 79 patients (4.5%). Actuarial 5-year survival was 73.5% +/- 1.6%.

CONCLUSIONS:

This clinical experience demonstrates that current technical strategies enable patients to undergo thoracoabdominal aortic aneurysm repair with excellent early survival and acceptable morbidity.

• Authors: Joseph S Coselli, Lori D Conklin, Scott A LeMaire
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 74 Issue 5 Pg. S1881-4; discussion S1892-8 (Nov 2002) ISSN: 0003-4975 [Print] Netherlands
• PMID: 12440686 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aortic Dissection (mortality, surgery)
• Aortic Aneurysm, Abdominal (mortality, surgery)
• Aortic Aneurysm, Thoracic (mortality, surgery)
• Blood Vessel Prosthesis Implantation
• Cause of Death
• Female
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Outcome and Process Assessment, Health Care
• Postoperative Complications (mortality)
• Risk Assessment
• Survival Rate