title: Factors influencing outcome after open surgical repair of juxtarenal abdominal aortic aneurysms.
abstract: The purpose of this study was to seek factors predicting outcome after open surgical repair of juxtarenal abdominal aortic aneurysms (AAAs). From a series of 733 patients treated for AAAs, 92 patients underwent elective conventional open repair with suprarenal clamping. We assessed postoperative cardiorespiratory and renal morbidity and mortality and survival at 1, 3, and 5 years. One patient (1.1%) died after an acute myocardial infarction. Postoperative complications including myocardial infarction and renal failure arose in 22 patients (23.9%). Significant predicting factors of renal failure were a preoperative creatinine clearance < or = 40 mL/min (p = .03) and female sex (p = .004). Kaplan-Meier survival analysis showed an overall survival rate of 98.9% at 1 year and 88.6% at 3 and 5 years. In patients carefully selected by preoperative imaging criteria to undergo open juxtarenal AAA repair, appropriate intraoperative management guarantees a good immediate postoperative outcome.
authors.affiliation: Department "Paride Stefanini", Policlicnico Umberto I, "Sapienza" University Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Speziale
authors.forename: Massimo
authors.initials: M
authors.lastname: Ruggiero
authors.forename: Enrico
authors.initials: E
authors.lastname: Sbarigia
authors.forename: Mario
authors.initials: M
authors.lastname: Marino
authors.forename: Danilo
authors.initials: D
authors.lastname: Menna
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D003250:Constriction; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D018579:Patient Selection; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
chemical_list: D015415:Biomarkers; D003404:Creatinine