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Outcomes of open repair of postdissection abdominal aortic aneurysms.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2020 Mar; Vol. 71 (3), pp. 774-779. Date of Electronic Publication: 2019 Jul 18. - Publication Year :
- 2020
-
Abstract
- Background: Evidence to guide management of postdissection abdominal aortic aneurysms (PDAAA) is lacking. This study describes the outcomes of open repair of PDAAA.<br />Methods: A retrospective cohort study was conducted of all consecutive patients treated with open repair for PDAAA after a Stanford type A or type B thoracic aortic dissection between January 2006 and December 2017 in two vascular referral centers. Preceding type B dissection treatment could include conservative or surgical management. Primary outcomes were 30-day mortality, complication rates, survival, and reintervention-free survival. Survival and reintervention-free survival were analyzed using the Kaplan-Meier method. Reintervention was defined as any endovascular or surgical intervention after the index procedure.<br />Results: Included were 36 patients (27 men [75%]) with a median age of 64 years (range, 35-81 years). The 30-day mortality was 2.7%. The median follow-up was 16 months (range, 0-88 months). The postoperative course was uneventful in 21 patients (58%). The most frequent complications were postoperative bleeding requiring repeat laparotomy (n = 4), pneumonia (n = 3), congestive heart failure (n = 2), new-onset atrial fibrillation (n = 2), mesenteric ischemia requiring left hemicolectomy (n=1), and ischemic cerebrovascular accident (n = 1). Renal failure requiring hemodialysis developed in one patient. The overall survival at 1 year was 88.8%. Reintervention-free survival was 95.5% after 1 year and 88.6% after 2 years.<br />Conclusions: Open repair of PDAAA can be performed with a low mortality rate and an acceptable complication rate, comparable with elective open repair of abdominal aortic aneurysms without dissection.<br /> (Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Aortic Dissection mortality
Aortic Aneurysm, Abdominal mortality
Female
Humans
Male
Middle Aged
Postoperative Complications epidemiology
Postoperative Complications mortality
Retrospective Studies
Survival Rate
Aortic Dissection surgery
Aortic Aneurysm, Abdominal surgery
Vascular Surgical Procedures
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 71
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31327610
- Full Text :
- https://doi.org/10.1016/j.jvs.2019.04.483