Surgery for thoraco-abdominal aortic aneurysm

Abstract

12 patients underwent resection of a thoraco-abdominal aortic aneurysm. There were 10 men and 2 women, ranging in age from 54-78 years (mean 65). Aortic arteriosclerosis was the primary etiology in 11, and Behcet's disease in the other 1. Most patients (7/12) presented with Type 3 aneurysm, extending from the distal descending thoracic aorta to the distal abdominal aorta; none had aortic dissection. 11 were operated on for symptoms related to the aneurysm: 3 of these had a contained rupture. The risk factors were chronic obstructive pulmonary disease in 10, hypertension (10), diffuse arteriosclerosis (8), ischemic heart disease (6), chronic renal failure (5) and cerebrovascular accident (1). The surgical technique in 11 was graft inclusion and visceral vessel reattachment. The main complication was acute renal failure, seen in 3 patients. None had spinal ischemia. Operative mortality was 33%. Of the 4 who died, 2 had myocardial infarction and 2 uncontrolled intraoperative bleeding. According to the literature the major complications are spinal cord ischemia and renal failure.