Reoperations for Thoracic and Thoracoabdominal Aneurysms

  • E. S. Crawford
  • J. S. Coselli
  • H. J. Safi

Abstract

Reoperation upon the thoracic and thoracoabdominal aorta deserves special consideration for two reasons: (1) because such procedures are often more difficult and can be associated with a higher morbidity and mortality, since the patients are often older with more advanced disease; and (2) because the techniques required to obtain exposure, control circulation and reconstruct often distorted anatomy are complex and technically challenging. Importantly, a clear understanding of the pathology and natural course involved in the development of conditions requiring reoperation is essential for planning surgical therapy. A critical analysis of primary operative procedures provides the opportunity to avert many secondary ones.

Keywords

Catheter Ischemia Albumin Steam Heparin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Becker HM, Stelter WJ, Kortmann H, Heberer G (1983) Anastomotic arterial aneurysms. Thorac Cardiovasc Surg 31: 2–7PubMedCrossRefGoogle Scholar
  2. Bentall M, DeBona A (1968) A technique for complete replacement of ascending aorta. Thorax 23: 338–339PubMedCrossRefGoogle Scholar
  3. Bergdahl LAL, Blackstone EH, Kirklin JW, Pacifico AD, Bargeron LM (1982) Determinants of early success in repair of aortic coarctation in infants. J Thorac Cardiovasc Surg 83: 736–742PubMedGoogle Scholar
  4. Bickerstaff LK, Pairolero PC, Hollier LH et al. (1983) Thoracic aortic aneurysms: an epidemiologic study. Surgery 92: 1103–1108Google Scholar
  5. Cabrol C, Pavie A, Mesnildrey P et al. (1986) Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries. J Thorac Cardiovasc Surg 91: 17–25PubMedGoogle Scholar
  6. Cooley DA, Livesay JJ (1981) Technique of “open” distal anastomosis for ascending and transverse arch resection. Cardiovasc Dis (Bull Tex Heart Inst) 8: 421–426Google Scholar
  7. Crafoord C, Nylin G (1945) Congenital coarctation of the aorta and its surgical treatment. J Thorac Surg 14: 347–361Google Scholar
  8. Crawford ES (1974) Thoraco-abdominal and abdominal aortic aneurysms involving renal, superior mesenteric, and celiac arteries. Ann Surg 179: 763–772PubMedCrossRefGoogle Scholar
  9. Crawford ES (1983) Marfan’s syndrome. Broad spectral surgical treatment of cardiovascular manifestations. Ann Surg 198: 487–505PubMedCrossRefGoogle Scholar
  10. Crawford ES, Crawford JS (1984) Diseases of the aorta including an atlas of angiographic pathology and surgical technique. Williams & Wilkins, BaltimoreGoogle Scholar
  11. Crawford ES, Snyder DM, Cho, GC, Roehm JOF Jr (1978) Progress in treatment of thoraco-abdominal and abdominal aortic aneurysms involving celiac, superior mesenteric, and renal arteries. Ann Surg 188: 404–422PubMedCrossRefGoogle Scholar
  12. Crawford ES, Walker HSJ III, Saleh SA, Norman NA (1981) Graft replacement aneurysm in descending thoracic aorta: results without bypass or shunting. Surgery 89: 73–85PubMedGoogle Scholar
  13. Crawford ES, Crawford JL, Stowe CL, Safi HJ (1984a) Total aortic replacement for chronic aortic dissection occurring in patients with and without Marfan’s syndrome. Ann Surg 199: 358–362PubMedCrossRefGoogle Scholar
  14. Crawford ES, Stowe CL, Crawford JL et al. (1984b) Aortic arch aneurysm: a sentinel of extensive aortic disease requiring subtotal and total aortic replacement. Ann Surg 199: 742–752PubMedCrossRefGoogle Scholar
  15. Crawford ES, Crawford JL, Safi HJ, Coselli JS (1985) Redo operations for recurrent aneurysmal disease of the ascending aorta and transverse aortic arch. Ann Thorac Surg 40: 439–455PubMedCrossRefGoogle Scholar
  16. Crawford ES, Crawford JL, Safi HJ et al. (1986) Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. J Vasc Surg 3: 389–404PubMedCrossRefGoogle Scholar
  17. Grey DP, Ott DA, Cooley DA (1983) Surgical treatment of aneurysm of the ascending aorta with aortic insufficiency. J Thorac Cardiovasc Surg 86: 864–877PubMedGoogle Scholar
  18. Hehrlein FW, Mulch J, Rautenburg HW, Schlepper M, Scheid HH (1986) Incidence and pathogenesis of late aneurysms after patch graft aortoplasty for coarctation. J Thorac Cardiovasc Surg 92: 222–230Google Scholar
  19. Jacobs NM, Godwin JD, Wolfe WG, Moore AV Jr, Breimann RS, Korogkin M (1982) Evaluation of the grafted ascending aorta with computed tomography. Radiology 145: 749–753PubMedGoogle Scholar
  20. Kouchoukos NT, Karp RB, Blackstone EH et al. (1980) Replacement of the ascending aorta and aortic valve with a composite graft: results in eighty-six patients. Ann Surg 192: 403–413PubMedCrossRefGoogle Scholar
  21. Kouchoukos NT, Marshall WG Jr, Wedige-Stecher TA (1986) Eleven year• éxperience with composite graft replacement of the ascending aorta and aortic valve. J Thorac CardiovascGoogle Scholar
  22. Surg 92: 691–705Google Scholar
  23. Livesay JJ, Cooley DA, Ventemiglia RA et al. (1985) Surgical experience in descending thoracic aneurysmectomy with and without adjuncts to avoid ischemia. Ann Thorac Surg 39: 37–46PubMedCrossRefGoogle Scholar
  24. McCready RA, Pluth JR (1979) Surgical treatment of ascending aortic aneurysms associated with aortic valve insufficiency. Ann Thorac Surg 28: 307–316PubMedCrossRefGoogle Scholar
  25. McNamara JJ, Pressler VM (1978) Natural history of arteriosclerotic thoracic aortic aneurysm. Ann Thorac Surg 26: 468–473PubMedCrossRefGoogle Scholar
  26. Miller DC, Stinson EB, Oyer PE et al. (1979) Operative treatment of aortic dissection: experience with 125 patients over a 16-year period. J Thorac Cardiovasc Surg 78: 365PubMedGoogle Scholar
  27. Miller DC, Stinson EB, Oyer PE et al. (1980) Concomitant resection of ascending aortic aneurysm and replacement of the aortic valve. J Thorac Cardiovasc Surg 79: 388–401PubMedGoogle Scholar
  28. Moreno-Cabral CE, Miller DC, Mitchell RS et al. (1984) Degenerative and atherosclerotic aneurysms of the thoracic aorta. J Thorac Cardiovasc Surg 88: 1020–1032PubMedGoogle Scholar
  29. Penkoske PA, Williams WG, Oiley PM et al. (1984) Subclavian arterioplasty repair of coarctation of the aorta in the first year of life. J Thorac Cardiovasc Surg 87: 894–900PubMedGoogle Scholar
  30. Pressler VM, McNamara JJ (1980) Thoracic aortic aneurysm: natural history and treatment. J Thorac Cardiovasc Surg 489–498Google Scholar
  31. Pressler VM, McNamara JJ (1985) Aneurysms of the thoracic aorta: review of 260 cases. J Thorac Cardiovasc Surg 98: 50–54Google Scholar
  32. Sade RM, Taylor AB, Chariker EP (1979) Aortoplasty compared with resection of coarctation of the aorta in young children. Ann Thorac Surg 28: 346–353PubMedCrossRefGoogle Scholar
  33. Sanchez GR, Balsara RK, Dunn JM, Mehta AV, O’Riordan AC (1986) Recurrent obstruction after subclavian flap repair of coarctation of the aorta in infants. J Thorac Cardiovasc Surg 91: 738–746PubMedGoogle Scholar
  34. Wheat MW Jr, Wilson JR, Bartley TD (1964) Successful replacement of the entire ascending aorta and aortic valve. JAMA 188: 717–719PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • E. S. Crawford
  • J. S. Coselli
  • H. J. Safi

There are no affiliations available

Personalised recommendations