Outcomes Following Contemporary Open Thoracoabdominal Aortic Aneurysm Extent I Repair: A Cross-Border Study

Area of Science:

• Vascular Surgery
• Aortic Aneurysm Repair
• Surgical Outcomes

Background:

• Open extent I thoraco-abdominal aortic aneurysm repair is crucial for patients without endovascular treatment options.
• Assessing outcomes and identifying risk factors for major adverse events is essential for optimizing patient care.

Purpose of the Study:

• To evaluate the outcomes of open extent I thoraco-abdominal aortic aneurysm repair.
• To identify factors associated with major adverse events and operative mortality in this patient cohort.

Main Methods:

• Retrospective multicenter study of 171 patients undergoing open extent I thoraco-abdominal aortic aneurysm repair.
• Major adverse events defined as operative death, stroke, paraplegia, paraparesis, or renal failure requiring renal replacement therapy.
• Univariable logistic regression used to identify risk factors for mortality and major adverse events.

Main Results:

• In-hospital mortality was 14.6%, with 23.3% experiencing major adverse events.
• Increasing age, previous myocardial infarction, coronary artery disease, and history of CABG were risk factors for adverse outcomes.
• Postoperative complications like ARDS and sepsis were significantly associated with adverse outcomes. Five-year survival was 58.6%.

Conclusions:

• Open extent I thoraco-abdominal aortic aneurysm repair is an established treatment for selected patients lacking endovascular alternatives.
• Despite significant risks, the procedure offers adequate long-term survival and a low aortic reintervention rate.
• Risk factor identification aids in improving patient selection and perioperative management.