[Fractionated-clamping for thoracoabdominal aortic aneurysm repair: report of 13 cases].
OBJECTIVE
Fractionated-clamping was applied to aneurysm repair in patients with thoracoabdominal aortic aneurysm(TAA), and its effects in decreasing operative mortality and severe complications such as renal failure and hemiplegia were discussed.


METHODS
Using improved shunting and cross-clamping technique, we repaired 13 thoracoabdominal aortae and their branches (9 males and 4 females). TAA Crawford type: type I one case, type II two cases, type III two cases and type IV three cases. TAA dissection Debakey type: type I one case, type III four cases (including 2 of ruptured aneurysm) and aorta stenosis one case.


RESULTS
Twelve procedures were performed successfully. One patient died of cardiac attack immediately before accomplishment of the operation with a operative mortality rate of 7.7% (1/13). Operative complications included acute necrotizing pancreatitis (1 case), ARDS (1), thoracic cavity bleeding (2), hemiplegia (1), and acute renal failure (1). The incidence rate of complications was significantly lower than that reported elsewhere.


CONCLUSIONS
Fractionated-clamping for thoracoabdominal aortic aneurysm repair is a renovation on the basis of Crawford procedure and aorta bypass method. Clinical results demonstrated that the procedure decreases the surgical mortality and the incidence rate of dangerous complications. Fractionated clamping for aorta replacement is a reasonable procedure under general anesthesia at normal temperature.
Guan
H
H
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Liu
C
C
Li
Y
Y
D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery; D003250:Constriction; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000209:etiology; D011183:Postoperative Complications / Q000401:mortality; D015996:Survival Rate; D014656:Vascular Surgical Procedures / Q000379:methods