Use of the temporal bypass technique in the treatment of thoracic and thoracoabdominal aortic aneurysms
| Autor: | V. V. Shlomin, M. L. Gordeev, P. B. Bondarenko, A. V. Gusinskiy, P. D. Puzdriak, E. A. Yurtaev, Yu. P. Didenko, I. G. Drozhzhin, N. Iu. Grebenkina, O. V. Fionik, E. S. Vedernikova, I. V. Kas’ianov |
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| Jazyk: | ruština |
| Rok vydání: | 2019 |
| Předmět: |
Aortic arch
medicine.medical_specialty RD1-811 medicine.medical_treatment Ischemia 030204 cardiovascular system & hematology Prosthesis 03 medical and health sciences 0302 clinical medicine dissection aorta medicine.artery medicine thoracoabdominal aortic aneurysm Thoracic aorta temporal shunt in aortic surgery descending thoracic aortic aneurysm Survival rate Aorta business.industry Mortality rate General Medicine medicine.disease Spinal cord Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis business |
| Zdroj: | Вестник хирургии имени И.И. Грекова, Vol 178, Iss 3, Pp 21-27 (2019) |
| ISSN: | 0042-4625 |
| Popis: | The OBJECTIVE was to analyze the experience of using a vascular prosthesis as a temporary bypass for spinal cord and visceral organs ischemia prevention during the clamping time in surgical reconstruction of thoracic and thoracoabdominal aortic aneurysm.MATERIAL AND METHODS. The study included 60 patients with the pathology of aortic arch, descending and thoracoabdominal aorta (TAAA) from 1997 to 2018. Among them, 42 (11 %) patients were diagnosed with TAAA I–IV types according to E. S. Crawford classification, 18 (32 %) – with the aortic arch aneurysm and the descending thoracic aorta. Planned interventions were performed in 43 (72 %) patients, emergency – in 17 (28 %). A temporary bypass made from vascular prosthesis with a diameter from 15 to 20 mm was used in 29 (48 %) cases as a protection of internal organs and the spinal cord against ischemia, and in 31 (52 %) surgical cases the reconstruction was performed with a cross clamping method.RESULTS. 30 days mortality was 16.6 % (n=10), total hospital mortality was 28.3 % (n=17). The mortality was 23.2 % (n=10) after planned interventions, and 41 % (n=7) – in emergency interventions. When using a temporary bypass during planned operation 9.3 % (n=4) of the patients died within 30 days, while cross clamping method without visceral protection showed 13.9 % death rate (n=6). Acute renal failure developed in 7 (11.6 %) cases and it was observed more often in the group without using of temporary bypass technique. The spinal cord ischemia turning into a spinal stroke occurred in 8 (13.3 %) cases. Five-year survival rate was 61 %.CONCLUSION. The use of a temporary bypass during the thoracic and thoracoabdominal aneurysms repair could be used for prevention of the visceral organs, kidneys and spinal cord ischemic complications during operations with need in cross clamping of the descending thoracic aorta. |
| Databáze: | OpenAIRE |
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