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Simultaneous operations for combined thoracic and abdominal aortic aneurysms.
Hisato Takagi1, Yoshio Mori, Hisashi Iwata
1First Department of Surgery, Gifu University School of Medicine, 40 Tsukasa, Gifu 500-8705, Japan.
Surgery Today
|August 21, 2003
Summary
Simultaneous repair of thoracic and abdominal aortic aneurysms is feasible. However, surgeons must consider the risk of paraplegia, particularly in complex cases involving both descending thoracic and abdominal aorta repair.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Aortic Aneurysm Repair
Background:
- Combined thoracic and abdominal aortic aneurysms present complex surgical challenges.
- Simultaneous repair strategies aim to address these complex pathologies efficiently.
Purpose of the Study:
- To evaluate the safety and appropriateness of simultaneous surgical repair for combined thoracic and abdominal aortic aneurysms.
Main Methods:
- A cohort of nine patients underwent simultaneous repair, prioritizing thoracic aortic aneurysm (TAA) repair followed by abdominal aortic aneurysm (AAA) repair.
- Techniques included selective cerebral perfusion and hypothermic circulatory arrest, with various methods for abdominal organ perfusion.
Main Results:
- All planned simultaneous AAA repairs were completed.
- The study observed an 11% operative mortality rate, including one death from aorto-broncho-esophageal fistulae.
- One patient developed paraplegia following simultaneous repair of descending thoracic and abdominal aorta.
Conclusions:
- Simultaneous repair of combined TAA and AAA is a viable option.
- The risk of paraplegia is a significant consideration, especially when repairing both the descending thoracic and abdominal aorta concurrently.