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Experience with 1509 patients undergoing thoracoabdominal aortic operations
L G Svensson1, E S Crawford, K R Hess
1Department of Surgery, Baylor College of Medicine, Houston, TX.
Journal of Vascular Surgery
|February 1, 1993
Summary
This study identified risk factors for death and complications after thoracoabdominal aortic repair. Key predictors of mortality and morbidity include patient age and clamp time, highlighting areas for improved surgical outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Aortic Surgery
Background:
- Thoracoabdominal aortic operations are complex procedures with significant risks.
- Identifying factors influencing outcomes is crucial for patient management.
Purpose of the Study:
- To retrospectively identify variables associated with early mortality and postoperative complications in patients undergoing thoracoabdominal aortic operations.
Main Methods:
- Retrospective review of 1509 patients undergoing 1679 thoracoabdominal aortic repairs (1960-1991).
- Analysis included preoperative, operative, and postoperative variables.
- Multivariate and stepwise logistic regression models were used.
Main Results:
- 30-day survival rate was 92%.
- Predictors of death included increasing age, creatinine, comorbidities (CAD, lung disease), and clamp time.
- Significant postoperative complications included cardiac issues, stroke, kidney failure (18%), and gastrointestinal hemorrhage (7%).
- Paraplegia/paraparesis occurred in 16%, predicted by clamp time, repair extent, rupture, age, aneurysm, and renal dysfunction.
Conclusions:
- Survival rates have improved, but paraplegia/paraparesis and kidney failure remain significant challenges.
- Further research is needed to address these persistent complications.