THORACOABDOMINAL AORTIC-ANEURYSMS - EXPERIENCE WITH 372 PATIENTS

被引：73

作者：

COSELLI, JS ^{[1
]}

机构：

[1] BAYLOR COLL MED,DEPT SURG,HOUSTON,TX 77030

来源：

JOURNAL OF CARDIAC SURGERY | 1994年 / 9卷 / 06期

关键词：

D O I：

10.1111/j.1540-8191.1994.tb00898.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The purpose of this study was to review retrospectively recent results in 372 patients with thoracoabdominal aneurysm treated by a single surgeon and to identify variables associated with early death, renal failure, and postoperative neurological deficits in patients undergoing thoracoabdominal aortic resection. Between January 11, 1986 and March 1, 1994, 203 males (55%) and 169 females (45%) (mean age 65 years) were treated. Aortic dissection was present in 93 patients (25%). The extent of repair included type I (137 patients), type II (95 patients), type III (73 patients), and type IV (67 patients). The overall 30-day survival rate was 95% (352/372 patients). The overall risk of postoperative neurological deficit was 6.4% (24/372 patients). In 309 patients treated without atriofemoral bypass, paraplegia or paraparesis developed in 23 (7.4%). In 63 patients in whom atriofemoral bypass was utilized, the overall risk of paraplegia or paraparesis was 1.6% (1/63). The use of atriofemoral bypass has had a favorable impact on postoperative neurological complications in selected patients.

引用

页码：638 / 647

页数：10

共 17 条

[1] Etheridge SN, Yee J, Smith JV, Et al., Successful resection of a large aneurysm of the upper abdominal aorta and replacement with homograft, Surgery, 38, pp. 1071-1075, (1955)
[2] Lefrak EA, Crawford ES, Thoracoabdominal aneurysm after resection and Dacron graft replacement of the descending thoracic aorta, Ann Surg, 176, pp. 765-768, (1972)
[3] Crawford ES, Thoracoabdominal and abdominal aortic aneurysm involving renal, superior mes‐enteric, and celiac arteries, Ann Surg, 179, pp. 763-772, (1974)
[4] Svensson LG, Crawford ES, Hess KR, Et al., Experience with 1509 patients undergoing thoracoabdominal aortic operations, J Vasc Surg, 17, pp. 357-370, (1993)
[5] Crawford ES, Svensson LG, Hess KR, Et al., A prospective randomized study of cerebrospinal fluid drainage to prevent paraplegia after high‐risk surgery on the thoracoabdominal aorta, J Vasc Surg, 13, pp. 36-46, (1991)
[6] Crawford ES, Mizrahi EM, Hess KR, Et al., The impact of distal aortic perfusion and SEP monitoring on prevention of paraplegia following aortic aneurysm operation, J Thorac Cardiovasc Surg, 95, pp. 357-367, (1988)
[7] Kouchoukos NT, Rokkas CK, Descending thoracic and thoracoabdominal aortic surgery for aneurysm or dissection: How do we minimize the risk of spinal cord injury, Semin Thorac Cardiovasc Surg, 5, pp. 47-54, (1993)
[8] Kouchoukos NT, Wareing TH, Izumoto H, Et al., Elective hypothermic cardiopulmonary bypass and circulatory arrest for spinal cord protection during operations on the thoracoabdominal aorta, J Thorac Cardiovasc Surg, 99, pp. 659-664, (1990)
[9] Coselli JS, Suprarenal aortic reconstruction: Pe‐rioperative management: Patient selection, patient workup, operative management, and postoperative management, Semin Vasc Surg, 5, pp. 146-156, (1992)
[10] Coselli JS, Suprarenal aortic reconstruction: En‐dovascular repair, Semin Vasc Surg, 5, pp. 180-191, (1992)

← 1 2 →