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Visceral infarction following aortic surgery.

W C Johnson, D C Nabseth

    Annals of Surgery
    |September 1, 1974
    PubMed
    Summary

    Visceral ischemia is an underestimated cause of death after aortic surgery. Identifying at-risk patients and performing visceral arterial reconstruction can prevent this complication.

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    Area of Science:

    • Vascular Surgery
    • Gastrointestinal Surgery
    • Surgical Outcomes

    Background:

    • Visceral ischemia is a significant but often overlooked complication of aortic surgery.
    • Previous literature suggests a low incidence of visceral ischemia following aortic procedures.

    Purpose of the Study:

    • To report on the incidence and impact of visceral ischemia in patients undergoing aortic surgery.
    • To discuss the pathophysiology and prevention strategies for visceral ischemia in this patient population.

    Main Methods:

    • Retrospective review of patients undergoing aortic surgery.
    • Analysis of operative mortality and causes of death, specifically related to visceral ischemia.
    • Literature review of reported cases of visceral ischemia after aortic surgery.

    Main Results:

    • Visceral ischemia contributed significantly to operative mortality in both aorto-iliac occlusive disease and aortic aneurysmectomy cases.
    • Reported incidence of colonic ischemia is 1.5% in over 6,100 aortic surgeries.
    • The authors experienced 9 cases of colon ischemia and 1 case of small bowel ischemia.

    Conclusions:

    • Patients at risk for visceral infarction should be identified via angiography.
    • Visceral arterial reconstruction should be considered alongside aortic reconstructive surgery.
    • Re-implantation of the patent inferior mesenteric artery (IMA) is crucial to prevent colon infarction after aortic aneurysm surgery.

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