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Angiología
versão On-line ISSN 1695-2987versão impressa ISSN 0003-3170
Resumo
PIZZAMIGLIO, Matteo et al. Results of open thoracoabdominal aneurysm repair with left partial cardiopulmonary bypass in a low-volume center. Angiología [online]. 2022, vol.74, n.4, pp.150-156. Epub 24-Out-2022. ISSN 1695-2987. https://dx.doi.org/10.20960/angiologia.00400.
Introduction:
open TAA repair is technically challenging, both from a surgical and circulatory point of view, and consequently carries a significant risk of operative morbidity and mortality. The aim of this study is to analyze results and complications of this type of intervention in our center.
Methods:
demographic characteristics, intraoperative data and postoperative complications of patients who underwent open thoracoabdominal aneurysm repair were collected between January 2005 and December 2019 in our center.
Results:
a total of 27 patients underwent thoracoabdominal aneurysm surgery. 25 patients had aortic aneurysm and 2 chronic dissection. 5 patients had already undergone previous aortic intervention. The mean age was 66.5 ± 7,77 and 21% were women. Regarding Crawford's classification of thoracoabdominal aneurysms, there were 1 Type I, 7 Type II, 9 Type III, 9 Type IV, and 1 Type V. 23 patients were treated electively and 4 urgently. Types I, II, III, and V TAAA were treated with left partial cardiopulmonary bypass.
Total mortality was 14.81 % and elective mortality was 8.69 %. The incidence of postsurgical paraparesis was 7.4 %. There were no cases of paraplegia or stroke. The incidence of acute myocardial infarction was 7.4 % and of pulmonary complications 48 %. The incidence of acute renal failure was 29.6 %. 5 of these eight patients required temporary hemodialysis. 1 patient presented postoperative visceral ischemia requiring left hemicolectomy. The median intensive care unit length of stay was 4 days and median hospital length of stay was 16 days.
Conclusions:
despite the complexity of open thoracoabdominal aneurysm surgery and the significant risk of complications, surgical repair with left partial cardiopulmonary bypass can be performed with acceptable results in a low-volume center.
Palavras-chave : Thoracoabdominal aneurysm; Open repair; Left partial bypass; Results; Postoperative mortality.