Komplikationen nach Rekonstruktion der Aorta

Complications following aortic reconstruction surgery

Zusammenfassung

Hintergrund

Die möglichen Komplikationen nach Rekonstruktionen der Aorta sind vielgestaltig und potenziell lebensbedrohlich. Neben den lange bekannten Komplikationen des offen-chirurgischen Aortenersatz (OAR) hat sich mit dem zunehmenden Einsatz endovaskulärer Techniken (EVAR) das Komplikationsspektrum erweitert und verschoben.

Ziel der Arbeit

Es werden die gängigsten Komplikationen sowohl der offen-chirurgischen als auch der endovaskulären Aortenchirurgie in zusammenfassender Weise dargestellt. Der Fokus liegt auf der Darstellung kardiovaskulärer bzw. nephrologischer Komplikationen, der Kolonischämie sowie Protheseninfektion und -fisteln. Auch die spinale Ischämie und Endoleaks nach EVAR werden besprochen. Zusätzlich wird die Darstellung durch epidemiologische Angaben und Schilderung der Risikofaktoren ergänzt und die jeweiligen prinzipiellen Therapieoptionen erläutert.

Fazit

Die rekonstruktive Chirurgie der Aorta kann mit ernsthaften Komplikationen assoziiert sein, die allen chirurgisch tätigen Fachdisziplinen in den Grundzügen bekannt sein sollten.

Abstract

Background

The potential complications following aortic reconstruction surgery are diverse and potentially life-threatening. Besides the well known complications of open aortic repair (OAR) the spectrum of complications has been extended and shifted by the growing use of endovascular aortic repair (EVAR).

Aim

The most common complications of open as well as endovascular aortic surgery are presented in a summarizing review. The focus is placed on the presentation of cardiovascular and nephrological complications, colonic ischemia, as well as aortic graft infections and graft fistulas. Spinal ischemia and endoleaks after EVAR are also discussed. Additionally epidemiological data, risk factors and basic therapeutic principles are outlined.

Conclusion

Aortic reconstruction surgery can be associated with severe complications, the main features of which should be known by all surgical specialties.

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Correspondence to E. Kleinspehn.

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Interessenkonflikt

E. Kleinspehn, F. Heidemann, C.A. Behrendt, T. Kölbel und E.S. Debus gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Kleinspehn, E., Heidemann, F., Behrendt, C. et al. Komplikationen nach Rekonstruktion der Aorta. Chirurg 86, 626–632 (2015). https://doi.org/10.1007/s00104-015-0030-z

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Schlüsselwörter

  • Komplikationen
  • Aortenchirurgie
  • Endovaskulärer Aortenersatz
  • Offen-chirurgischer Aortenersatz
  • Aortenaneurysma

Keywords

  • Complications
  • Aortic surgery
  • Endovascular aortic repair
  • Open aortic repair
  • Aortic aneurysm