Abstract 14775: Current Results of Open Repair of Descending Thoracic and Thoracoabdominal Aortic Aneurysms
Introduction: Open repair of thoracic and thoracoabdominal aortic aneurysms (DTA and TAAA respectively) constitutes a benchmark for comparison with endovascular techniques. Hypothesis. To evaluate the current results of the open repair of DTA and TAAA. Methods. Open DTA and TAAA repair was performed on 675 consecutive patients (210 TAA and 465 TAAA). Three surgical techniques were used based on the type of the aneurysm and the risk profile of the patient: clamp and saw, partial bypass or hypothermic circulatory arrest. Spinal drain was used in 82.7% of patients. Regression analysis was performed to identify independent determinants of in-hospital and late outcomes and individual major postoperative complications. Propensity matching (PPM) was used to compare results of the different surgical techniques Results. Operative mortality was 5.6% (38/675); incidence of postoperative spinal cord injury, stroke, need for tracheostomy, myocardial infarction and dialysis were 2.8%, 0.7%, 7.7%, 0.6% and 5.2% respectively. Kaplan Mayer survival at five-year was 57.8%. Female gender, urgent operation and preoperative dialysis were independent predictors of adverse in-hospital adverse events. Preoperative renal and respiratory failure were associated with follow-up death. Female gender and preoperative chronic pulmonary disease were associated with postoperative need for tracheostomy, whereas preoperative renal failure, urgent operation and peripheral vascular disease predicted the need for postoperative dialysis. Due to the low number of events, logistic regression analysis was not possible for predictors of spinal cord injury. In the PPM groups no difference was found in the early and late outcome between patients treated with different techniques (see table).
Conclusion: In the current era open TAA and TAAA repair allows excellent outcomes.
Author Disclosures: M. Gaudino: None. C. Lau: None. M. Munjal: None. M. Elsayed: None. U. Benedetto: None. L.N. Girardi: None.
- © 2015 by American Heart Association, Inc.