title: Recent experience with thoracoabdominal aneurysm repair.
abstract: Thoracoabdominal aneurysm repair was carried out in 55 patients during the period from January 1978 to June 1988. Considering the volume of experience and application of a routine for preoperative and intraoperative management, the experience was divided as follows: group 1 1978 to 1985 (26 patients) and group 2 1985 to 1988 (29 patients). Clinical features of the two groups differed only in the incidence of emergency operations (group 1 [6/18, 30%] vs group 2 [2/29, 8%]). Operative mortality in elective operations improved substantially in recent experience (group 1 [50%] vs group 2 [7.4%]). Significant reductions in total operative time, operative blood loss, and total aortic cross-clamping times paralleled and, in part, explained the improvement in overall surgical results seen in group 2 patients. Spinal cord injury occurred in 7.2% of the entire cohort. Nonfatal but major complications occurred in 25% of group 2 patients, with the most common being prolonged ventilatory assistance (12%). Current results with thoracoabdominal aneurysm repair both establish its safety and help to provide guidelines in selecting patients for elective repair.
authors.affiliation: Surgical Service, Massachusetts General Hospital, Boston 02114.
authors.forename: R P
authors.initials: RP
authors.lastname: Cambria
authors.forename: D C
authors.initials: DC
authors.lastname: Brewster
authors.forename: A C
authors.initials: AC
authors.lastname: Moncure
authors.forename: B
authors.initials: B
authors.lastname: Ivarsson
authors.forename: R C
authors.initials: RC
authors.lastname: Darling
authors.forename: J K
authors.initials: JK
authors.lastname: Davison
authors.forename: W M
authors.initials: WM
authors.lastname: Abbott
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D001012:Aorta, Abdominal; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012120:Respiration Disorders / Q000209:etiology; D012121:Respiration, Artificial