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Operative experiences with thoracoabdominal aortic aneurysms.

D Killen, M Gorton, W Reed

    Missouri Medicine
    |December 8, 2000
    PubMed
    Summary

    Surgical repair of thoracoabdominal aneurysms has improved, offering better protection against ischemic injury. Recent outcomes show high survival rates, supporting more aggressive surgical intervention for these aortic conditions.

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    Area of Science:

    • Vascular Surgery
    • Aortic Aneurysm Repair
    • Thoracoabdominal Aneurysms

    Background:

    • Aneurysms of the descending thoracic and abdominal aorta require complex surgical management.
    • Thoracoabdominal aneurysms present unique challenges due to their extensive nature.
    • Protecting vital organs and the spinal cord from ischemia during repair is critical.

    Purpose of the Study:

    • To evaluate the outcomes of surgical resection for thoracoabdominal aneurysms.
    • To assess improvements in protecting abdominal viscera and spinal cord from ischemic injury.
    • To determine the long-term survival rates following thoracoabdominal aneurysm repair.

    Main Methods:

    • Retrospective analysis of 690 aortic aneurysm resections over 27 years.
    • Specific focus on the 30 cases of thoracoabdominal aneurysms.

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  • Evaluation of operative techniques aimed at preventing ischemic complications.

    • Main Results:

    • Thirty thoracoabdominal aneurysms (4.3%) were resected.
    • Significant improvements were noted in protecting abdominal viscera and spinal cord from ischemic injury.
    • Operative survivors demonstrated good late survival (68% at 5 years).
    • The last 12 patients survived surgery, with 9 alive at follow-up.

    Conclusions:

    • Surgical outcomes for thoracoabdominal aneurysms have progressively improved.
    • Enhanced protection against ischemic injury has been achieved.
    • The favorable surgical results justify a more aggressive approach to resecting these aneurysms.