Thoracoabdominal Aortic Aneurysm Repair.
10.4326/jjcvs.23.97
- VernacularTitle:胸腹部大動脈りゅうの手術成績
- Author:
Keishu Yasuda
;
Makoto Sakuma
;
Yoshiro Matsui
;
Norihiko Shiiya
;
Masakatsu Asada
;
Hiroshi Matsuura
;
Tatsuzo Tanabe
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1994;23(2):97-100
- CountryJapan
- Language:Japanese
-
Abstract:
We report 18 cases of thoracoabdominal aortic aneurysm repair. Most causes of the thoracoabdominal aortic aneurysm were atherosclerotic lesions (56%) or inflammatory changes (39%), such as Takayasu's aortitis and Behçet's disease. The Crawford procedure was performed in 13 patients, patch aortoplasty in 3, the Hardy procedure in 1 and extra-anatomic bypass in 1. As an adjunct, temporary bypass was employed in 8 patients and F-F bypass in 7 patients. Visceral arteries were perfused selectively during aortic cross-clamp. A total of 39% of all patients required emergency surgery for rupture, and among inflammatory aneurysms 86% of them ruptured. The early mortality rate was 0% in non-ruptured thoracoabdominal aneurysms, 42.9% in ruptured and 16.7% overall. There were 3 severe post-operative complications including one each of paraplegia, non-occlusive intestinal ischemia and rupture. All of them turned resulted in in-hospital death and the in-hospital mortality rate was 33.3%. There was no late death among atherosclerotic thoracoabdominal aortic aneurysms. However both Behçet's disease cases required re-operation for rupture at the anastomotic site in the late postoperative period and one patient died. One Marfan's syndrome patient also died 3 years postoperatively. We conclude that the Crawford procedure with F-F bypass is an effective and safe approach to thoracoabdominal aortic aneurysm repair and yields good clinical results.
