Key result
Total abdominal approach for type IV TAAA linked to minimal thoracic complications and ~12% perioperative mortality.
Why the study?
The total transabdominal approach for type IV thoracoabdominal aneurysm repair was proposed to potentially improve outcomes by avoiding chest opening.
What are the operative morbidity and mortality rates associated with the total abdominal approach for repair of type IV thoracoabdominal aortic aneurysm?
Observational (n=26)
What are the operative morbidity and mortality rates associated with the total abdominal approach for repair of type IV thoracoabdominal aortic aneurysm?
The total abdominal approach for type IV thoracoabdominal aortic aneurysm repair is a reasonable alternative to a full thoracoabdominal incision, with acceptable perioperative mortality and minimized thoracic complications.
Answers are grounded in this paper and cite their sources.
Supports feasibility of abdominal-only repair for type IV TAAA; hypothesis-generating and requires comparative trials before wider adoption.
BACKGROUND: The total transabdominal approach for thoracoabdominal aneurysm (TAA) was described in 1995 and it was suggested that outcome might be improved if the chest was not opened. This study reports early results of the technique with respect to operative morbidity and mortality rates for patients with abdominal aortic aneurysm extending to the diaphragm. METHODS: Between 1995 and 1998, 26 patients (median age 71 (range 52-84) years) underwent repair of a type IV TAA using a total abdominal approach and medial visceral rotation. RESULTS: Three patients presented with a contained leak. All survived but one developed paraplegia. Other complications included chest infection (five patients), myocardial infarction (three), reoperation for bleeding (three) and temporary dialysis in one patient. There were three perioperative deaths, two from myocardial infarction and one from multisystem organ failure. CONCLUSION: The total abdominal approach for the repair of type IV TAA is a reasonable alternative to a full thoracoabdominal incision. Thoracic complications are minimized, renal and visceral ischaemia times are low, and the perioperative mortality rate is acceptable.
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Dunning et al. (1999) conducted an observational in type IV thoracoabdominal aortic aneurysm (n=26). Total abdominal approach was evaluated on operative morbidity and mortality rates. Total abdominal approach for the repair of type IV thoracoabdominal aortic aneurysm in 26 patients resulted in 3 perioperative deaths and minimized thoracic complications.
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