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1980: descending aortic aneurysmectomy without adjuncts to avoid ischemia. 1993 update
1Department of Cardiovascular-Thoracic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Rush Medical College, Chicago, Illinois 60612.
The Annals of Thoracic Surgery
|April 1, 1993
Summary
Simple aortic cross-clamping for descending aortic aneurysm resection is safe and effective. This method resulted in fewer complications and no deaths or paraplegia compared to using extracorporeal circulation or shunts.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Aortic Aneurysm Repair
Background:
- Descending aortic aneurysms pose significant surgical risks.
- Previous reports suggested the safety of simple aortic cross-clamping.
- The study aimed to compare outcomes of different aortic occlusion techniques.
Purpose of the Study:
- To evaluate the safety and efficacy of simple aortic cross-clamping versus adjuncts for descending aortic aneurysm resection.
- To compare complication rates, including mortality and paraplegia, between the two techniques.
Main Methods:
- Retrospective analysis of 36 patients undergoing descending aortic aneurysm resection.
- Group 1: Aortic occlusion with extracorporeal circulation or temporary shunts.
- Group 2: Simple aortic cross-clamping without adjuncts to prevent ischemia.
Main Results:
- Group 2 (simple cross-clamping) had no early deaths or paraplegia.
- Group 1 experienced the only 2 early deaths and 2 instances of paraplegia.
- Fewer overall complications were observed in Group 2, with two-thirds of patients having an uneventful recovery.
Conclusions:
- Simple aortic cross-clamping is a safe and effective method for descending aortic aneurysm resection.
- This technique is associated with a lower complication rate compared to using extracorporeal circulation or shunts.
- The findings support the liberal use of simple aortic cross-clamping in managing these lesions.