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Recent Experience With Thoracoabdominal Aneurysm Repair

Richard P. Cambria, MD; David C. Brewster, MD; Ashby C. Moncure, MD; Bengt Ivarsson, MD; R. Clement Darling, MD; J. Kenneth Davison, MD; William M. Abbott, MD
Arch Surg. 1989;124(5):620-624. doi:10.1001/archsurg.1989.01410050110021.
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• Thoracoabdominal aneurysm repair was carried out in 55 patients during the period from January 1978 to June 1988. Considering the volume of experience and application of a routine for preoperative and intraoperative management, the experience was divided as follows: group 1 1978 to 1985 (26 patients) and group 2 1985 to 1988 (29 patients). Clinical features of the two groups differed only in the incidence of emergency operations (group 1 [6/18, 30%] vs group 2 [2/29, 8%]). Operative mortality in elective operations improved substantially in recent experience (group 1 [50%] vs group 2 [7.4%]). Significant reductions in total operative time, operative blood loss, and total aortic cross-clamping times paralleled and, in part, explained the improvement in overall surgical results seen in group 2 patients. Spinal cord injury occurred in 7.2% of the entire cohort. Nonfatal but major complications occurred in 25% of group 2 patients, with the most common being prolonged ventilatory assistance (12%). Current results with thoracoabdominal aneurysm repair both establish its safety and help to provide guidelines in selecting patients for elective repair.

(Arch Surg. 1989;124:620-624)


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