No abstract

Based on these limited data, it appears that patients with minimal aortic injuries (grades I and II) may be managed medically, with the majority resolving within 8 weeks. Minimal aortic injury is associated with low mortality and excellent intermediate-term outcomes. Further prospective studies are required to validate these findings.

Background. We reviewed the efficacy of intraoperative intercostal nerve cryoanalgesia for pain control in patients undergoing descending and thoracoabdominal aortic aneurysm repairs.Methods. During 2013 and 2017, 241 patients underwent descending and thoracoabdominal aortic aneurysm repair. Of those, 38 patients were treated with intraoperative cryoanalgesia to the intercostal nerves at the level of 4th to 10th under electromyography guidance and were compared with patients who did not receive cryoanalgesia. Both groups received multilevel paravertebral block and local infiltration with liposomal bupivacaine. Numerical pain scale scores and amount of opioid usage in morphine milligram equivalences on the first to fourth and eighth postoperative days were collected. We excluded patients from the study who were extubated after the third postoperative day or who were reintubated.Results. One hundred twenty-six patients met the inclusion criteria: 28 in the cryoanalgesia group and 98 in the control group. Preoperative patient demographics

Background. The purpose of this study was to redefine indications of open descending and thoracoabdominal aortic aneurysm repair in the younger population.Methods. Between 1991 and 2017, 2012 patients undergoing descending and thoracoabdominal aortic aneurysm repair at our institution were divided into 2 groups for comparison: younger (<50 years; 276 [14%]) and older ( ‡50 years; 1736 [86%]). Patient demographics and perioperative outcomes were retrospectively reviewed.Results. Younger patients had significantly more heritable thoracic aortic disease (HTAD; 53% vs 9%, P < .001) and chronic dissections (64% vs 26%, P < .001) and fewer comorbidities. The younger cohort underwent more extent II repairs (28% vs 15%, P < .001). Operative mortality was significantly lower in younger patients (6% vs 17%, P < .001). Significant disabling complications (composite of operative mortality, paraplegia/paraparesis, stroke, and dialysis) were seen in 17% of the younger patients and in 40% of older patients 40% (P < .001). In multivariate analysis, extent of repair and chronic obstructive pulmonary disease were independent