Subsequent proximal aortic operations in 123 patients with previous infrarenal abdominal aortic aneurysm surgery

Abstract

On the basis of the significant prevalence of subsequent proximal aortic aneurysms and the high mortality rate associated with their rupture, we recommend resection of the entire infrarenal aorta during abdominal aortic aneurysm replacement, followed by long-term surveillance with biannual computed tomography or magnetic resonance imaging scanning of the chest and abdomen. Early diagnosis is facilitated by a high index of suspicion and allows surgical intervention to occur before life-threatening rupture. Both emergency and elective proximal aortic surgery in these patients can be performed with acceptable levels of morbidity and mortality.

Open thoracic or thoracoabdominal aortic aneurysm repair after previous abdominal aortic aneurysm surgery

“…Amount of estimated blood loss appeared to be a significant predictor of morbidity (P Ͻ .023). Coselli 24 showed that longer aortic clamp time and visceral ischemic times were significantly associated with in-hospital death, non-oliguric renal failure, and neurological deficit. Fox 18 described that mortality appeared to be associated with age (Ͻ72 years vs Ն72 years of age, P ϭ .04), proximal extent of the aneurysm (P ϭ .05), rupture (P ϭ .06), history of myocardial infarction (P ϭ .03), congestive heart failure (P ϭ .01), and arrhythmia (P ϭ .005).…”

Diretrizes para o tratamento cirúrgico das doenças da aorta da Sociedade Brasileira de Cirurgia Cardiovascular

“…Similarly, many experimental and clinical studies [47, 154,159,[178][179][180][181][182][183][184] have been developed trying to define the role of the motor-evoked or somatosensorial potentials, in monitoring the activity of the segmental medulla and in the prevention of the paraplegia, although with very variable results and with recommendations still not consensual in respect to the efficacy as an isolated method in the prevention of medullar ischemia [179].…”

Diretrizes para a cirurgia das doenças da aorta

“…Similarmente, vários estudos experimentais e clíni-cos 48,158,163,[186][187][188][189][190][191][192][193] têm sido desenvolvidos tentando definir o papel dos potenciais evocados motores ou somato-sensoriais, na monitorização da atividade da medula segmentar e na prevenção da paraplegia, embora com resultados muito variáveis, e de recomendação ainda não consensual, quanto à eficácia como método isolado na prevenção da isquemia medular 179 .…”