Thoracoabdominal Aortic Replacement for Crawford Extent II Aneurysm After Thoracic Endovascular Aortic Repair

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2017 Feb 17

PMID 28203407

Citations 1

Authors

Haiou Hu

Tie Zheng

Junming Zhu

Yongmin Liu

Ruidong Qi

Lizhong Sun

Affiliations

Soon will be listed here.

Abstract

Background: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR).

Methods: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015. The indications included: diameter >5.0 cm; persistent pain; size increase >0.5 cm/year; and no suitable landing zone for re-TEVAR. Five patients underwent surgery under deep hypothermic cardiac arrest, two under mild hypothermic cardiopulmonary bypass, and four under direct aortic cross-clamping under normothermia. Two patients had Marfan syndrome.

Results: There were no in-hospital deaths. Continuous renal replacement therapy was required in three patients. One patient needed re-intubation, and two patients had prolonged intubation (>72 h). One patient sustained paraplegia after surgery but recovered during follow-up. Cerebrospinal fluid drainage were used in four patients (3 immediately in the operation room, and 1 in the intensive care unit when the patient suffered paraplegia). One patient died during follow-up.

Conclusions: TAAR represents a feasible option for the treatment of Crawford extent II aneurysms after TEVAR, with acceptable surgical risks and favorable results.

Citing Articles

Early and mid-term outcomes of open thoracoabdominal aortic aneurysm repair after thoracic endovascular aortic repair.

Lin J, Liu W, Yang C, Jian K, Xia Y, Peng H BMC Cardiovasc Disord. 2024; 24(1):182.

PMID: 38532333 PMC: 10964665. DOI: 10.1186/s12872-024-03837-8.

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