title: Morbidity and mortality after extent II thoracoabdominal aortic aneurysm repair.
abstract: BACKGROUND
  Surgical repair of Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) carries substantial risk for morbidity and mortality. The purpose of this study was to analyze the results of a large consecutive series of extent II TAAA repairs and identify factors that influence morbidity and survival.
  
  
  METHODS
  Of 1,415 consecutive patients who underwent TAAA operations over a 13-year period, 442 (31.2%) had extent II repairs. Data from a prospectively maintained database were analyzed to determine which factors were associated with death and major complications.
  
  
  RESULTS
  The operative mortality was 10.0% (44 patients). Postoperative complications included paraplegia/paraparesis in 33 patients (7.5%), pulmonary complications in 158 (35.7%), and renal failure in 69 (15.9%). Multivariable analysis revealed that renal insufficiency (odds ratio [OR] 2.6), increasing age (OR 1.1/year), and increasing red blood cell transfusion requirements (OR 1.1/U) were predictors for mortality; renal insufficiency (OR 2.8) and peptic ulcer disease (OR 9.3) were predictors of renal failure; and rupture (OR 6.3) was a predictor of paraplegia. Left heart bypass was an independent protective factor against paraplegia (OR 0.4).
  
  
  CONCLUSIONS
  This contemporary experience demonstrates acceptable levels of morbidity and mortality in this high-risk group. Left heart bypass was found to provide protection against paraplegia in these patients.
authors: The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and The Methodist DeBakey Heart Center, Houston, Texas 77030, USA. jcoselli@bcm.tmc.edu
authors: Joseph S
authors: JS
authors: Coselli
authors: Scott A
authors: SA
authors: LeMaire
authors: Lon D
authors: LD
authors: Conklin
authors: Cüneyt
authors: C
authors: Köksoy
authors: Zachary C
authors: ZC
authors: Schmittling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010264:Paraplegia / Q000209:etiology; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000209:etiology; D012307:Risk Factors; D015996:Survival Rate; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods