RETRACTED: Prevention of renal failure in patients undergoing thoracoabdominal aortic aneurysm repair

Abstract

Distal aortic and selective renal blood perfusion is an effective measure to protect renal function during TAAA repair, but only if perfusion is provided with adequate volume and pressure. This technique also averts dialysis in most patients with preoperative renal failure.

Open surgical repair of ruptured juxtarenal aortic aneurysms with and without renal cooling: Observations regarding morbidity and mortality

“…25,27 Renal failure is related to MOF, 24,25 which has been reported as a common complication after ruptured aortic surgery and is highly correlated with lethal outcome. 8,10,20,21 Preoperative measures to preserve renal function with cooling have been applied previously in thoracoabdominal aortic aneurysm repair 28 and during elective repair of juxtarenal aortic aneurysms 11 with beneficial effects on postoperative renal function. Also, in the current study of RJAA, we observed a tendency toward preservation of renal function and better outcome with the application of cold renal perfusion.…”

Endovascular Treatment of Thoracoabdominal Aneurysm

“…Vigilance is necessary to ensure that components of the modular system do not migrate and that material fatigue does not cause kinking or fracture of stents. [13][14][15]17,18,27]. The lack of thoracotomy in the endovascular approach likely contributes to the lower rate of pulmonary failure (4.5-6.8%) reported in two published series [21•,37•].…”

“…Paraplegia appears most commonly in patients who had prior surgery in another aortic territory and in those with extensive (group II) thoracoabdominal disease. The rate of paraplegia in centers of excellence and in larger-volume series reporting this event is 1-10% [10, 14,18,[24][25][26][27]. The etiology of paraplegia is theorized to be multifactorial, including spinal cord ischemia during surgery and decreased spinal cord perfusion afterward.…”

“…Temporary or permanent dialysis after surgery has been reported, and the perioperative rate of new-onset dialysis ranges from 3% to 13% in published series [9, 14,16,27]. Reimplantation of the renal arteries and the requisite ischemic period during visceral revascularization likely are the largest sources of morbidity; however, it has been clearly shown that preoperative renal dysfunction predicts not only mortality, but also worsening renal dysfunction in the perioperative period [29].…”

“…Definitions are not standardized, and the retrospective nature of reporting diminishes the reliability of these numbers. Pulmonary failure is the most common complication reported after open TAAA repair; perioperative rates are reported to be 17-58% [13][14][15]17,18,27]. Gastrointestinal complications including ischemia and bleeding occur in 2.5% and 1.5% of cases, respectively [30].…”