for missing values. SOD was absent in 712 patients and present in 157 patients with the following pattern: 66 renal, 86 mesenteric, and 5 mixed SOD. Patients with SOD presented with higher incidence of preoperative renal impairment ( 61[38.9%] vs 175 [24.6%]; P < .01), peripheral artery disease (60 [38.2%] vs 162 [22.8%]; P < .01), and Marfan syndrome (39 [24.8%] vs 56 [7.9%]; P < .01; Table I). The distribution of Crawford extents was significantly different between the compared groups (P < .01) along with the operative conduct (Table II). In the unmatched population, the SOD group was affected by higher mortality ( 19[12.1%] vs 30 [4.2%]; P < .01), SCI (10 [6.4%] vs 15 [2.1%]; P < .01), need for tracheostomy (17 [10.8%] vs 45 [6.3%]; P ¼ .04), dialysis (19 [12.1%] vs 26 [3.7%]; P < .01), and MAEs (51 [32.5%] vs 90 [12.6%]; P < .01). Propensity score matching led to 150 pairs in which SOD retained a significant association to mortality (18 [12.0%] vs 7 [4.7%]; P ¼ .03), SCI (10 [6.7%] vs 2 [1.3%]; P < .03), and MAEs (49 [32.7%] vs 23 [15.3%]; P < .01). Logistic regression confirmed that SOD significantly predicted mortality (odds ratio [OR], 3.48; 95% confidence interval [CI], 1.73-6.99), SCI (OR, 3.37; 95% CI, 1.14-10.01), and MAEs (OR, 3.15; 95% CI, 1.84-5.40; Table III). Conclusions: SOD is a significant predictor of SCI and mortality in patients undergoing open DTA/TAAA repair.
Endologix, Irvine, Calif) was deployed with adequate overlap with the proximal cuff (Fig, B and C). The patient then underwent laparotomy for an extended left hemicolectomy and transverse colostomy.Results: We noted prompt postoperative improvement in sepsis and hemodynamic status. Serial postoperative imaging up to 9 months has shown near-resolution of periaortic inflammatory changes and widely patent aortic and left renal artery repairs. Suppressive oral antibiotics are maintained.Conclusions: Chimney endovascular aortic repair is a viable option for emergent repair of secondary aortoenteric fistula in a select group of high-risk patients.
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