Outcomes of open repair of postdissection abdominal aortic aneurysms
Background: Evidence to guide management of postdissection abdominal aortic aneurysms (PDAAA) is lacking. This study describes the outcomes of open repair of PDAAA. Methods: A retrospective cohort study was conducted of all consecutive patients treated with open repair for PDAAA after a Stanford type A or type B thoracic aortic dissection between January 2006 and December 2017 in two vascular referral centers. Preceding type B dissection treatment could include conservative or surgical management. Primary outcomes were 30-day mortality, complication rates, survival, and reintervention-free survival. Survival and reintervention-free survival were analyzed using the Kaplan-Meier method. Reintervention was defined as any endovascular or surgical intervention after the index procedure. Results: Included were 36 patients (27 men [75%]) with a median age of 64 years (range, 35-81 years). The 30-day mortality was 2.7%. The median follow-up was 16 months (range, 0-88 months). The postoperative course was uneventful in 21 patients (58%). The most frequent complications were postoperative bleeding requiring repeat laparotomy (n = 4), pneumonia (n = 3), congestive heart failure (n = 2), new-onset atrial fibrillation (n = 2), mesenteric ischemia requiring left hemicolectomy (n=1), and ischemic cerebrovascular accident (n = 1). Renal failure requiring hemodialysis developed in one patient. The overall survival at 1 year was 88.8%. Reintervention-free survival was 95.5% after 1 year and 88.6% after 2 years. Conclusions: Open repair of PDAAA can be performed with a low mortality rate and an acceptable complication rate, comparable with elective open repair of abdominal aortic aneurysms without dissection.
|Keywords||Abdominal aortic aneurysm, Aneurysm, dissecting, Aortic dissection, Open repair|
|Persistent URL||dx.doi.org/10.1016/j.jvs.2019.04.483, hdl.handle.net/1765/118412|
|Journal||Journal of Vascular Surgery|
Vos, C.G. (Cornelis G.), van Lammeren, G.W. (Guus W.), Werson, D.A.B, Wille, J.C, Kropman, R.H.J, Vahl, A, … de Vries, J.-P.P.M. (Jean-Paul P.M.). (2019). Outcomes of open repair of postdissection abdominal aortic aneurysms. Journal of Vascular Surgery. doi:10.1016/j.jvs.2019.04.483