Morbidity and mortality after extent II thoracoabdominal aortic aneurysm repair

Coselli, Joseph S.; LeMaire, Scott A.; Conklin, Lori D.; Köksoy, Cüneyt; Schmittling, Zachary C.

doi:10.1016/s0003-4975(02)03370-2

Cited by 203 publications

(127 citation statements)

References 37 publications

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“…As suggested earlier, the international literature does document particularly poor survival for patients managed medically, 1,2 improved significantly following intervention. 6 There are no data published on survival with and without intervention in the UK; however, unpublished survival in our own group of postoperative aortic patients in Liverpool compares favourably with published survival for medically treated patients.…”

supporting

confidence: 51%

Intervention on thoracic and thoracoabdominal aortic aneurysms: can the UK offer a service?

et al. 2012

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supporting

confidence: 51%

Intervention on thoracic and thoracoabdominal aortic aneurysms: can the UK offer a service?

et al. 2012

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“…Two Extent III patients underwent repair utilising partial cardiopulmonary bypass and aortic clamping. The mean CPB and HCA were 246 min (95% CL 217-278) and 21 min (95% CL [16][17][18][19][20][21][22][23][24], respectively. The mean intercostals, hypogastric, visceral and renal ischaemic times (15 8C) were 40 min (95% CL 34-46), 51 min (95% CL 34-69), 92 min (95% CL 38-167) and 86 min (95% CL 32-139), respectively.…”

Section: Operative Details and Outcomesmentioning

confidence: 98%

Presentation and outcome of Marfan's syndrome patients with dissection and thoraco-abdominal aortic aneurysm

Kalkat

Rahman

Kotidis

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Background: In Marfan's syndrome, there is a paucity of data regarding intervention criteria for surgery of the dissected thoraco-abdominal aorta. Methods: A retrospective analysis of 22 Marfan's patients with distal aortic dissection managed between September 1999 and April 2006 was performed. Serial diameters and linear expansion rates were calculated from imaging studies and the outcome of intervention was analysed.Results: There were 14/22 male patients (median age 38 years), and 18 had prior aortic surgery. Surgery was recommended in 20 patients and undertaken in 19 (1 died prior to operation). Of the operated patients, 2 presented with rupture, 2 with airway obstruction, 1 with intermittent paraplegia and 14 underwent planned surgery for increased expansion rate or pain. All patients had residual type A or chronic type B dissection. The median aortic dimension at surgery was 6.7 cm (interquartile range (IQR) 5.5-8.2). The preoperative mean expansion rate increased from 0.5 cm/year to 1.7 cm/year ( p < 0.001), prior to operation. Fifteen patients underwent Crawford Extent II, two underwent Extent I and two underwent Extent III repair. Profound hypothermia and CSF drainage was used in 16 and 18 patients, respectively. There was no early mortality, paraplegia or renal failure. At a median postoperative follow-up of 56 months (range 6-86), the survival of the operated cohort was 90%. Conclusions: Thoraco-abdominal aortic aneurysm repair in Marfan's syndrome can be performed with good outcomes. Intervention should be based on size or accelerated expansion. Any role of endovascular management needs careful consideration. #

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“…In patients with COPD and in smokers, pulmonary function is significantly reduced in 23e36%, leading to oxygenation problems during peri-operative single-lung ventilation, prolonged post-operative ventilatory support, and pneumonia. 225 Pre-operative spirometry and blood gas analysis can detect pulmonary compromise, and appropriate respiratory training programmes and medical treatment can be initiated to improve lung function. Pre-existing renal insufficiency is also a predictor of post-operative renal failure and mortality and should be taken into account when considering OR.…”

Section: Managementmentioning

confidence: 99%

“…232 The majority of publications on the results of open TAAA repair originate from individual series, coming from highly specialized centers. 30,225,227 The results of these experienced centres report mortality rates varying between 5% and 15%. Major complications include respiratory failure (up to 60%), neurological deficits (3e18%), and renal failure (3e15%).…”

Section: Managementmentioning

confidence: 99%