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Surgery of thoracoabdominal aortic aneurysms
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1984
Summary
Surgical repair of thoracoabdominal aortic aneurysms is effective and safe. This study shows successful outcomes in eight patients, recommending elective surgery for most cases.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Aortic Aneurysm Surgery
Background:
- Arteriosclerotic aneurysms of the thoracoabdominal aorta pose significant surgical challenges.
- Ruptured aneurysms present a critical surgical emergency.
Observation:
- A specific surgical approach utilizing a left diaphragm-splitting thoracoabdominal incision and a retroperitoneal route provided excellent exposure.
- Temporary aortofemoral shunting proved effective in preventing perioperative ischemic damage to abdominal organs and the spinal cord.
- A meticulous graft reattachment technique minimized ischemic times for visceral and renal arteries.
Findings:
- All eight patients recovered without major complications, with normalized creatinine and liver enzyme levels within a month.
- No paraplegic complications were observed, even with intra-aneurysmal ligation of arteries in most patients.
- Long-term follow-up showed seven patients remained well with functioning grafts; one occlusion occurred without sequelae.
Implications:
- Most thoracoabdominal aortic aneurysms are amenable to surgical correction with acceptable risk.
- The described surgical technique and adjuncts contribute to favorable patient outcomes.
- Elective surgical intervention is strongly recommended for thoracoabdominal aortic aneurysms.