Open repair of juxtarenal aortic aneurysms: 10-years of experience in a single center

Abstract

Objectives: This study aims to evaluate the long-term surgical outcomes of juxtarenal aortic aneurysms (JAAs). Patients and methods: We retrospectively analyzed a total of 21 consecutive patients (20 males, 1 female; mean age 64.8±11.8 years; range, 31 to 80 years) who underwent open repair of JAAs using a suprarenal clamp between May 2009 and May 2019. Data including baseline demographic and clinical characteristics of the patients, preoperative risk factors, radiographic images, and postoperative data were recorded. Results: Of all patients, six had a failed endograft. The median time to the completion of surgery was 286 (range, 192 to 628) min and the median renal ischemia time was 42 (range, 20 to 82) min. Renal artery endarterectomy (n=5), reimplantation (n=2), and an extension graft interposition (n=2) were the additional procedures to ensure kidney perfusion. During a follow-up of 48 months, six patients required dialysis and three were permanent, and the overall mortality rate was 33.3%. Conclusion: The results of JAA repair become steadily worsened due to the changes in the rate and severity of constitutional risk factors during the last decade. The increasing number of failed endovascular procedures increases the need for a suprarenal clamp. Therefore, failed endograft should be considered an etiological factor and a risk factor for the open repair of JAAs currently.