Ramírez VAF, Careaga RG, Téllez LS, Argüero SR

Language: Spanish
References: 44
Page: 118 - 127
PDF size: 109.00 Kb.

ABSTRACT

Objective: To present our clinical results of the surgical treatment in patients with aneurysm of the thoracic aorta. Material and methods: From January, 1999 to August, 2003, 39 patients with thoracic aorta aneurysms surgically treated with aortic valved grafting, knitted graft, dacron patch repair or homograft procedure were analyzed. There were evaluated: risk factor, type of aneurysm, tiem for ischemic arrest, cardiopulmonary bypass, myocardial protection, perioperative and long-term evolution, and morbimortality. Results: Of the 39 patients, 16 (41.0%) have secondary dissected aneurysm, and 23 (59.0%) only aneurysm. Of 16 patients with aortic dissection, 14 (87.5%) have type A dissection and two (12.5%) type B. In 89.7% of the patients the surgical repair was made under cardiopulmonary bypass and 2 patients have left heart bypass only. For myocardial protection it was employed modified St. Thomas cardioplegic solution in 31 patients (88.6%) and histidine-trypthophane-ketoglutarate solution in four cases (11.4%). In 35 of the cases (88.7%), the aneurysm was located in ascending aorta, one (2.5%) in the aortic arch and three (7.7%) on the descending aorta. The main risk factors were smoking, high blood pressure and Marfan Syndrome in 21, 20 and 12 patients respectively. Associated procedures was realized in nine cases. Twenty seve patients have any postoperative complication and three patients died after surgical procedure (7.7%). Conclusions: It was concluded that with optimal myocardial, brain, spine and target organs protection, and an adequate surgical procedure, the treatment of the aortic aneurysm is safe and useful, and increase the quality of life and survival.

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