Surgical Treatment of the Descending Thoracic Aorta: An analysis of 22 cases

Lee, Hong Sup; Lee, Sun Hoon; Yoon, Young Chul; Kuh, Bon Il; Kim, Chang Ho

Abstract

BACKGROUND: The purpose of this study was to evaluate and analyze the surgical techniques and postoperative complications in patients undergoing operations for descending thoracic aortic aneurysms. MATERIAL AND METHOD: The data of 22 major operations between March 1987 and August 1997 were retrospectively reviewed. RESULT: There were 18 men and 4 women with a mean age of 49 years (range 33 years to 82 years). The cause of the aneurysm was aortic dissection in 13 patients, atherosclerosis in 3, mycotic in 3, trauma in 2 and uncertain in 1. The operative techniques were resection and graft replacement in 16, axillofemoral bypass graft in 2, femorofemoral bypass graft in 2, exclusion, aneurysmorrhaphy in 1 and transfemoral stent insertion in 1. During the operation, 16 cases were performed under total aortic clamp. Among the 16 patients, femorofemoral bypass was used in 14 cases and previously made shunt in 2 cases. The mean total aortic clamp time was 91 minutes and the mean extracorporeal circulation time was 116 minutes. One death occurred in an excluded patient on the 52 postoperative day due to a rupture of the aneurysm. Postoperative complications were paraplegia in 1 case, acute renal failure in 1 case and acute respiratory failure in 1 case.
CONCLUSION
Although surgical treatment of the descending thoracic aneurysm has many postoperative complications, good surgical results can be achieved with a proper patient selection and fine surgical techniques.