Thoracoabdominal aortic aneurysm repair: review and update of current strategies

Ann Thorac Surg. 2002 Nov;74(5):S1881-4; discussion S1892-8. doi: 10.1016/s0003-4975(02)04139-5.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Dissecting / mortality
  • Aneurysm, Dissecting / surgery*
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Aneurysm, Thoracic / mortality
  • Aortic Aneurysm, Thoracic / 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