The Turkish Journal of Vascular Surgery
Yazarlar: Ahmet SARITAŞ, Şeref A. KÜÇÜKER, Okan YURDAKÖK, Ümit KERVAN, Çağatay TUNCEL, Özgür ERSOY
Konular:-
Anahtar Kelimeler:Descending thoracic aortic aneurysm,Simple cross-clamp technique,Paraplegia
Özet: Pupose: The preferred method for the repair of descending thoracic aortic aneurysm is crucial for the spinal cord preservation. Recently for the repair of aortic aneurysms with limited extension, there are literature data about the similar outcomes for clamp-and- sew technique when compared with the other methods using left heart bypass. Methods: Between February 2002 and April 2005, 22 consecutive elective descending thoracic aortic aneurysm cases underwent graft replacement with the use of simple cross-clamp technique. The aortic aneurysms in these cases were localized between the left subclavian artery and diaphragm. Seventeen patients were male and 5 were female and their mean age was 47.6±14.4 ranging between 20-80 years. Cerebrospinal fluid drainage was applied for 48 to 72 hours postoperatively to all but 6 patients whom were operated urgently, had technical problems or had proximal aneurysms with limited extension. All demographic, operative and postoperative data were collected retrospectively from patient files and then analyzed. Results: Average aortic cross-clamp time was 42 minutes. Total of 4 patients, one patient during operation and three patients postoperatively were lost (18.1%). One patient had paraplegia (4.5%) and one patient had paraparesis which resolved on second postoperative month. Due to low patient number none of the preoperative risk factors were identified as statistically important for paraplegia or mortality. Conclusion: Recent literature data reports similar outcomes for descending thoracic aortic aneurysms, repaired either by simple cross clamp or by left heart bypass techniques. Preferring the simple cross-clamp technique for thoracic aneurysms limited within the diaphragm seems to be as efficacious as other techniques that perfuse the distal aorta. (Turkish J Vasc Surg 2006;15(2):11-16).