title: Surgical treatment of abdominal aortic aneurysms located close to the visceral arteries: report of three cases.
abstract: The standard surgical treatment for abdominal aortic aneurysms (AAA) is in situ replacement of the infrarenal aorta, which is associated with a low mortality rate. On the other hand, thoracoabdominal aortic aneurysms (TAA) remain a formidable challenge and the complications that can occur may be severe including neurologic dysfunction and renal failure. We report herein three cases of patients with AAA located very close to the visceral arteries, for which in situ replacement of the infrarenal aorta was not feasible due to severe inflammation and adhesion. Therefore, aortic stump closure and in situ bypass grafting was performed to avoid reconstruction of the visceral arteries. No major complications or operation-related deaths occurred. Thus, while in situ replacement is usually recommended over bypass grafting for patients whose aneurysms are located very close to the visceral arteries, aortic stump closure and in situ bypass grafting should be considered as a more effective surgical option.
authors.affiliation: Department of Cardiovascular Surgery, Oita Medical University, Hasama-machi, Oita 879-5593, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sako
authors.forename: T
authors.initials: T
authors.lastname: Hadama
authors.forename: O
authors.initials: O
authors.lastname: Shigemitsu
authors.forename: S
authors.initials: S
authors.lastname: Miyamoto
authors.forename: H
authors.initials: H
authors.lastname: Anai
authors.forename: T
authors.initials: T
authors.lastname: Soeda
authors.forename: S
authors.initials: S
authors.lastname: Urabe
authors.forename: T
authors.initials: T
authors.lastname: Wada
authors.forename: E
authors.initials: E
authors.lastname: Iwata
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome