Related Experiment Videos
[Aortic aneurysm and aortic injury--surgical treatment and follow-up]
Insights
This study reviewed 90 aortic surgeries, finding high mortality for acute dissections. Preoperative coronary angiography in older patients and surgeon responsibility for long-term follow-up are recommended.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Context:
- Review of 90 patients undergoing aortic surgery between 1980 and 1990.
- Surgical indications included aortic dissection, rupture, and aneurysms.
- Procedures involved deep hypothermia and circulatory arrest for aortic arch reconstruction.
Purpose:
- To summarize surgical experience and outcomes in aortic disease management.
- To identify risk factors and causes of mortality.
- To provide recommendations for improving patient care and follow-up.
Summary:
- Overall mortality was 18.8%, with higher rates for emergency surgeries (29.5%) and Type I acute dissections (29.4%).
- Leading early death causes were myocardial infarction and cerebral injury.
- No fatal outcomes occurred with deep hypothermia and circulatory arrest for aortic arch reconstruction.
Impact:
- Highlights the need for preoperative coronary angiography in older patients.
- Emphasizes the critical role of the surgeon in long-term patient follow-up.
- Provides insights into managing complex aortic pathologies and associated risks.
Abstract:
This study summarizes our experience with 90 patients (68 male and 22 female, mean age 57.2 years). From Jan. 1980 to Feb. 1990, 51.1% underwent surgery for dissection of the aorta; the rest for acute aortic ruptures, false and true aneurysms. Procedures with reconstruction of the aortic arch were performed in cases of deep hypothermia and circulatory arrest (no fatal courses). The overall death rate was 18.8% (emergency 29.5%, elective 8.7%). Acute dissections Type I had the highest perioperative mortality with 29.4%. The leading causes of early death were myocardial infarction (23.5%) and cerebral injury (23.5%). Therefore coronary angiograms should be performed preoperatively in older patients. A major problem in our experience is the long-term followup examination which should remain the surgeon's responsibility.