title: Thoracoabdominal aortic aneurysm repair through redo left-sided thoracotomy.
abstract: BACKGROUND
  The outcome of thoracoabdominal aortic aneurysm repair through redo-left thoracotomy after operations for descending thoracic aortic aneurysms was investigated.
  
  
  METHODS
  Between May 1982 and March 2003, 100 patients underwent thoracoabdominal aortic aneurysm repair in elective surgery without profound hypothermic circulatory arrest. Thirty of these patients had previously undergone operations for descending thoracic aortic aneurysms. To evaluate the influence of previous descending thoracic aortic aneurysm repairs on the results of thoracoabdominal aortic aneurysm replacements, patients were divided into two groups: (1) patients who had previously undergone descending thoracic aortic aneurysm repair (group I; n = 30), and (2) patients who had not previously undergone descending thoracic aortic aneurysm repair (group II; n = 70).
  
  
  RESULTS
  The distal aortic perfusion time and operation time were both longer in group I than in group II, but there was no significant difference between the two groups in total selective visceral and renal perfusion time or aortic clamp time. In-hospital mortality rates were 13% in group I and 19% in group II (p = 0.52). Major postoperative complications included paraplegia (10% of patients in group I and 4.3% of patients in group II; p = 0.36), renal failure requiring hemodialysis (20% of patients in group I and 11% of patients in group II; p = 0.35), respiratory failure (30% of patients in group I and 19% of patients in group II; p = 0.22).
  
  
  CONCLUSIONS
  Previously descending thoracic aortic aneurysm and redo-left thoracotomy do not adversely affect the outcome of thoracoabdominal aortic aneurysm repair.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. nobuyosh@sapmed.ac.jp
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Kawaharada
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Morishita
authors.forename: Johji
authors.initials: J
authors.lastname: Fukada
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hachiro
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Tomio
authors.initials: T
authors.lastname: Abe
mesh_terms: D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D013504:Cardiovascular Surgical Procedures / Q000379:methods / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D015996:Survival Rate; D013908:Thoracotomy; D016896:Treatment Outcome