Early Results in Surgical Treatment of Thoracic Aortic Aneurysm

Ahn, Byoung Hee; Shin, Seong Hyeon; Na, Kook Joo

Abstract

This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07+/-11.76 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median sternotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta and/or partial or total aortic arch were performed in 9 patients, descending aorta and/or thoracoabdominal aorta in 3 and total aorta in 1. Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta and/or aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67+/-29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in 1.