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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Reoperations for aortic false aneurysms after cardiac surgery.

Pietro G Malvindi1, Bart P van Putte, Robin H Heijmen

  • 1Department of Cardiac Surgery, IRCCS Istituto Clinico Humanitas, Rozzano, Italy. pmalvin@tin.it

The Annals of Thoracic Surgery
|October 26, 2010
PubMed
Summary

Reoperation for aortic false aneurysm after cardiac surgery offers acceptable survival rates despite high complication risks. This study highlights outcomes for patients undergoing surgical repair of this rare complication.

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Area of Science:

  • Cardiovascular Surgery
  • Aortic Surgery
  • Surgical Complications

Background:

  • Aortic false aneurysm is a rare but serious complication following cardiac surgery.
  • Risk factors include aortic dissection, infection, arterial degeneration, and surgical technique.
  • Surgical reoperation is typically required, despite advances in less invasive methods.

Purpose of the Study:

  • To evaluate the outcomes of surgical reoperation for postsurgical aortic false aneurysm.
  • To identify risk factors associated with mortality and complications.
  • To assess long-term survival and freedom from reoperation.

Main Methods:

  • Retrospective review of 43 patients undergoing reoperation for aortic false aneurysm over 14 years.
  • Analysis of 18 perioperative variables using univariate and multivariate methods.
  • Evaluation of in-hospital mortality, postoperative complications, survival rates, and reoperation rates.

Main Results:

  • In-hospital mortality was 6.9%, with postoperative complications occurring in 39% of patients.
  • Coronary artery disease and postoperative sepsis were independent risk factors for hospital mortality.
  • 1, 5, and 10-year survival rates were 94%, 79%, and 68%, respectively; freedom from reoperation was 86% at 1 year and 72% at 5-10 years.

Conclusions:

  • Surgical reoperation for postsurgical aortic false aneurysm is associated with acceptable mortality rates.
  • Despite a high rate of postoperative complications, outcomes are favorable in the mid- and long-term.
  • This approach provides a viable option for managing this complex surgical complication.