Is routine postaneurysmectomy hemodynamic assessment of the inferior mesenteric artery circulation helpful?
All patients with an abdominal aortic aneurysm treated during a 27-year period by one surgical group at the MidAmerica Heart Institute were included in this study. A prospective routine postaneurysmectomy hemodynamic assessment of the inferior mesenteric artery (IMA) circulation was performed in a test group of consecutive patients operated on by one surgeon. When a mean IMA stump pressure </= approximately 50 mmHg was found, the IMA was reimplanted. Postoperatively, patients were monitored for clinical evidences of ischemic colitis. The occurrence of ischemic colonic injury was documented by colonoscopy, laparotomy, or autopsy. The incidences of ischemic colitis in the test group, a historical control group, and a concomitant control group were determined and compared. Routine hemodynamic assessment of the postaneurysmectomy IMA circulation did not favorably affect the outcome with regard to the occurrence of clinically evident ischemic colitis.
Killen
D A
DA
MidAmerica Heart Institute, Saint Luke's Hospital, and the Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Reed
W A
WA
Gorton
M E
ME
Muehlebach
G F
GF
Borkon
A M
AM
Piehler
J M
JM
Wathanacharoen
S
S
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology; D002423:Cause of Death; D017091:Colitis, Ischemic / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000503:physiopathology* / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D012092:Replantation; D015996:Survival Rate; D016896:Treatment Outcome