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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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[Ruptured Non-dissecting Thoracic Aortic Aneurysm].

Yukio Kuniyoshi1

  • 1Department of Thoracic and Cardiovascular Surgery, School of Medicine, University of the Ryukyu, Okinawa, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
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Summary

Ruptured thoracic aortic aneurysms have poor outcomes, with high mortality. Elective open surgery or thoracic endovascular aortic repair (TEVAR) offers better survival rates for these critical vascular conditions.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Thoracic Aneurysm Research

Background:

  • Operative outcomes for non-dissecting thoracic aneurysms have improved.
  • Ruptured thoracic aneurysms, however, remain associated with high mortality and poor survival rates.
  • Sudden death occurs in approximately 60% of patients with ruptured aneurysms.

Observation:

  • The 30-day postoperative mortality for non-ruptured non-dissecting thoracic aneurysms is 2.71%.
  • The 30-day postoperative mortality for ruptured non-dissecting thoracic aneurysms is 19.0%.
  • Thoracic endovascular aortic repair (TEVAR) is a primary option for hemodynamically unstable patients with ruptured aortic aneurysms.

Findings:

  • TEVAR for ruptured thoracic aneurysms has a reported mortality rate of 10.87%.
  • This mortality rate for TEVAR is lower compared to open surgical repair.
  • Elective surgical intervention, either open or TEVAR, is crucial for preventing mortality.

Implications:

  • Timely, elective treatment of thoracic aortic aneurysms is essential for improving patient survival.
  • TEVAR presents a potentially life-saving alternative for ruptured thoracic aneurysms, especially in high-risk patients.
  • Further research into optimizing TEVAR and open surgical techniques for ruptured aneurysms is warranted.