Aneurysm of Abdominal Aorta

Bakey, Michael E. De; Crawford, E. Stanley; Cooley, Denton A.; Morris, George C.; Royster, Thomas S.; Abbott, Walter P.

doi:10.1097/00000658-196410000-00007

Cited by 203 publications

(14 citation statements)

References 9 publications

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“…The authors suggested that advanced age and life-limiting comorbidities give pause to otherwise proceeding with elective repair of AAA and that improvement in long-term survival after OAR would be a result of better patient selection. 12,13 Debakey et al 13 demonstrated similar findings. Survival was greatest in those with no hypertension or cardiovascular disease (74% vs 51%) at 5 years.…”

Section: Discussionmentioning

confidence: 81%

“…In our series, survival was improved in those without hypertension or coronary disease compared with those with these conditions, but not to the extent of prior reports (77% vs 82% at 5 years). 13 This highlights the effect on survival from other comorbid conditions, such as COPD and renal disease, in contemporary practice.…”

Section: Discussionmentioning

confidence: 99%

“…Our survival results are similar to contemporary randomized trials (75% at 5 years) 9 and are favorable compared with historical series of AAA repair with 5-year survival of 58% to 63%. 12,13 …”

Section: Discussionmentioning

confidence: 99%

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Optimal selection of patients for elective abdominal aortic aneurysm repair based on life expectancy

Martino

Goodney

Nolan

et al. 2013

Journal of Vascular Surgery

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Objective Elective abdominal aortic aneurysm (AAA) repair is beneficial when rupture is likely during a patient’s expected lifetime. The purpose of this study was to identify predictors of long-term mortality after elective AAA repair for moderately sized AAAs (<6.5-cm diameter) to identify patients unlikely to benefit from surgery. Methods We analyzed 2367 elective infrarenal AAA (<6.5 cm) repairs across 21 centers in New England from 2003 to 2011. Our main outcome measure was 5-year life-table survival. Cox proportional hazards analysis was used to describe associations between patient characteristics and 5-year survival. Results During the study period, 1653 endovascular AAA repairs and 714 open AAA repairs were performed. Overall, 5-year survival rates were similar by procedure type (75% endovascular repair, 80% open repair; P = .14). Advanced age ≥75 years (hazard ratio [HR], 2.0; P < .01) and age >80 years (HR, 2.6; P < .01), coronary artery disease (HR, 1.4; P < .04), unstable angina or recent myocardial infarction (HR, 4.6; P < .01), oxygen-dependent chronic obstructive pulmonary disease (HR, 2.7; P < .01), and estimated glomerular filtration rate <30 mL/min/1.73 m2 (HR, 2.8; P < .01) were associated with poor survival. Aspirin (HR, 0.8; P < .03) and statin (HR, 0.7; P < .01) use were associated with improved survival. We used these risk factors to develop risk strata for low-risk, medium-risk, and high-risk groups with survival, respectively, of 85%, 69%, and 43% at 5 years (P < .001). Conclusions More than 75% of patients with moderately sized AAAs who underwent elective repair in our region survived 5 years, but 4% were at high risk for 5-year mortality. Patients with multiple risk factors, especially age >80 years, unstable angina, oxygen-dependent chronic obstructive pulmonary disease, and estimated glomerular filtration rate <30 mL/min/1.73 m2, are unlikely to achieve sufficient long-term survival to benefit from surgery, unless their AAA rupture risk is very high. (J Vasc Surg 2013;58:589–95.)

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Optimal selection of patients for elective abdominal aortic aneurysm repair based on life expectancy

Martino

Goodney

Nolan

et al. 2013

Journal of Vascular Surgery

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“…When fistulisation is present hemoptoe or hematemesis appears. A chest x-ray shows enlargement of the mediastinal shadow or a mass in the chest [4,5,16,17]. In the case of an abdominal aneurysm we find severe abdominal pain radiating to the rectum and buttock.…”

Section: Discussionmentioning

confidence: 99%

Gastro-Intestinal Bleeding Due to Arterio-Enteric Fistula

Schramek¹,

Weisz²,

Erlik³

1971

Digestion

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This article deals with the problem of gastro-intestinal bleeding due to aorto-enteric fistulisation. Four such cases are presented, with connection to different parts of the gastro-intestinal tract, in the thorax and the abdomen. An until now unpublished localisation, that into the coecum, is presented. The description of the symptomatology and a survey of the literature are given. The importance of an existent time interval between the first and the fatal, last hemorrhage is emphasized, an interval thatallows life saving corrective aortic surgery.

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“…Abdominal aortic aneurysm (AAA) is commonly associated with coronary artery disease (CAD) [1], which is the most common cause of death after AAA repair [2]. Coronary artery bypass grafting (CABG) before AAA repair decreases postoperative cardiac mortality rates [3] but increases the incidence of postoperative AAA rupture.…”

Section: Introductionmentioning

confidence: 99%

Combined transdiaphragmatic off-pump and minimally invasive coronary artery bypass with right gastroepiploic artery and abdominal aortic aneurysm repair

Gürer¹,

Haberal

Özsoy

2013

Am J Case Rep

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Patient: Male, 74Final Diagnosis: Abdominal aortic aneurysm (AAA)Symptoms: Palpable abdominal massMedication: —Clinical Procedure: Abdominal aortic aneurysm repairSpecialty: SurgeryObjective:Rare diseaseBackground:Coronary artery disease is common in elderly patients with abdominal aortic aneurysms. Here we report a case of the combination of surgical repair for abdominal aortic aneurysm and off-pump and minimally invasive coronary artery bypass surgery.Case Report:A 74-year-old man who presented at our clinic with chest pain was diagnosed with an abdominal aortic aneurysm. His medical history included right coronary artery stenting. Physical examination revealed a pulsatile abdominal mass on the left side and palpable peripheral pulses. Computed tomography scans showed an infrarenal abdominal aneurysm with a 61-mm enlargement. Coronary angiography revealed 80% stenosis in the stent within the right coronary artery and 20% stenosis in the left main coronary artery. The patient underwent elective coronary artery bypass grafting and abdominal aortic aneurysm repair. Abdominal aortic aneurysm repair and transdiaphragmatic off-pump and minimal invasive coronary artery bypass grafting with right gastroepiploic artery were performed simultaneously in a single surgery.Conclusions:We report this case to emphasize the safety and effectiveness of transdiaphragmatic off-pump and minimally invasive coronary artery bypass surgery with abdominal aortic aneurysm repair. This combined approach shortens hospital stay and decreases cost.

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Aneurysm of Abdominal Aorta

Cited by 203 publications

References 9 publications

Optimal selection of patients for elective abdominal aortic aneurysm repair based on life expectancy

Optimal selection of patients for elective abdominal aortic aneurysm repair based on life expectancy

Gastro-Intestinal Bleeding Due to Arterio-Enteric Fistula

Combined transdiaphragmatic off-pump and minimally invasive coronary artery bypass with right gastroepiploic artery and abdominal aortic aneurysm repair

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