Ruptured aneurysms of the thoracoabdominal aorta: a case series.
Fifteen cases of ruptured thoracoabdominal aneurysm (-TAA) were encountered in 1987-July 1994. These patients included 13 males (86.6%), 2 females (13.4%) with a mean age of 66.3 years (range 58-78). Surgery was performed on 13 patients of whom 6 (46.1%) died within 30 days. The two other patients had died of heart failure prior to surgery. In 8 of these patients (53.4%) the condition was not diagnosed until clear symptoms had appeared. The ruptured aneurysms were thoracic in 9 cases (60%), abdominal in 6 (40%). The maximum aneurysm diameter in the most frequently ruptured group was 6.1-8 cm (in 9 patients-60%)./ For 5 cases (33.4%) the maximum diameter of ruptured aneurysms included dorsolumbar pain. In one patient a concomitant aortobronchial fistula had produced rupture. Low blood pressure was found in 9 cases (60%). In 5 cases (38.4%) curative surgery was performed within 24 hours of the onset of symptoms. In this group, the mortality rate was 40% (2 patients). In the remaining 8 cases, on whom surgery could not be performed within 24 hours (range 25 hours-4 months) the mortality rate was 50% (4 cases). All four cases of paraplegia (30.7%) were encountered among patients in the second group, 2 of whom died. Follow-up revealed a 5-year mortality rate of 71.4%.
Rampoldi
V
V
Milan University Institute of General and Cardiovascular Surgery, IRCCS Ospedale Maggiore Policlinico, Italy.
Arpesani
A
A
Giorgetti
P L
PL
Rignano
A
A
Trimarchi
S
S
Conti
D
D
Ruberti
U
U
D000368:Aged; D017542:Aneurysm, Ruptured / Q000401:mortality / Q000601:surgery; D001012:Aorta, Abdominal; D001013:Aorta, Thoracic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009422:Nervous System Diseases / Q000209:etiology; D011183:Postoperative Complications; D016019:Survival Analysis; D013997:Time Factors