Key result
Open thoracoabdominal aortic aneurysm repair in a single-center cohort of 19 patients resulted in an in-hospital mortality rate of 31.6% and a spinal cord deficit rate of 10.5%.
Why the study?
Open surgery remains the gold standard for thoracoabdominal aortic aneurysm repair, but few cardiovascular centers have experience with the procedure.
What are the postoperative outcomes of open thoracoabdominal aortic aneurysm repair in a single center?
Cohort (n=19)
No
What are the postoperative outcomes of open thoracoabdominal aortic aneurysm repair in a single center?
Open thoracoabdominal aortic aneurysm repair remains a high-risk procedure with significant in-hospital mortality (31.6%), underscoring the need for specialized tertiary vascular centers.
High mortality in this small cohort warrants caution and referral to specialized centers; leaves open comparative effectiveness of endovascular alternatives.
Aim: The gold standard repair of thoracoabdominal aortic aneurysm (TAAA) is still open surgery. However, few cardiovascular centers are experienced in TAAA repair. The aim of this study was to examine the methods and four-year outcomes of the open TAAA repair program initiated by a single surgical team. Material and Methods: In this retrospective cohort, patients who were operated for TAAA between August 2018 and March 2022 were collected. Patients treated with the endovascular approach were excluded. After exclusion, 19 patients were included in our analysis. As postoperative outcomes, in-hospital mortality, spinal cord deficit, major neurologic complications, need for dialysis, and visceral ischemia were collected. Results: Crawford extent II TAAA repair was performed in 10 (52.6%) patients, Crawford extent III in 5 (26.3%) patients, and Crawford extent IV in 4 (21.1%) patients. In hospital mortality occurred in 6 (31.6%) patients. The causes of mortality were perioperative myocardial infarction in 2 (10.5%) patients, visceral ischemia in 1 (5.3%) patient, multisystem organ failure in 3 (15.8%) patients. The highest mortality rate (50.0%) occurred in Crawford extent II repair. Spinal cord deficit developed in 2 (10.5%) patients. Conclusion: Thoracoabdominal aortic aneurysm surgery is associated with high mortality rates. Open thoracoabdominal aortic aneurysm repair programs in tertiary vascular centers should be supported, to improve the surgical results of thoracoabdominal aortic aneurysm repair.
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Aydın et al. (2022) conducted a cohort in Thoracoabdominal aortic aneurysm (n=19). Open thoracoabdominal aortic aneurysm repair was evaluated on In-hospital mortality. Open thoracoabdominal aortic aneurysm repair in a single-center cohort of 19 patients resulted in an in-hospital mortality rate of 31.6% and a spinal cord deficit rate of 10.5%.
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