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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
1
|
| pubmed:dateCreated |
1990-2-22
|
| pubmed:abstractText |
During the past 2 decades 102 consecutive patients (77 men and 25 women) with multiple aortic aneurysms underwent 201 aortic reconstructions. These procedures (174 elective and 27 emergent) represented 3.4% of the 5837 aortic aneurysm operations performed. Seventy-five (30.9%) of the 243 aneurysms occurred in the infrarenal aorta, 65 occurred in the descending aorta (26.7%), 56 occurred in the thoracoabdominal aorta (23.0%), and 47 occurred in the ascending aorta or arch (19.3%). Ages ranged from 20 to 81 years (mean 63.3 years). Smoking history and abnormal electrocardiographic tracings were present in 84.3% of the patients, hypertension was present in 77.5%, and obstructive lung disease was present in 60.8%. Multiple aortic aneurysms were present at the time of the first repair in 55 patients (53.9%). Twelve patients had one procedure, 81 had two, and nine had three. Sixteen (17.8%) of the 90 patients who had multiple operations had a subsequent operation for complications of the unrepaired aneurysm (rupture 12, symptoms 4). Fourteen perioperative deaths occurred among the 174 elective repairs (8.0%), and 11 occurred among the 27 emergent procedures (40.7%). Procedure mortality increased with the ordinal number of elective operations and was 4.4% for the first, 10.4% for the second, and 33.3% for the third. Seven of 21 patients (33.3%) who had simultaneous repair of at least two aortic aneurysms died in the perioperative period. Overall, 77 of the 102 patients (75.5%) survived all surgical procedures to repair their multiple aortic aneurysms; of these, 63 had complete resection of all known aneurysms. Follow-up was complete in all patients and averaged 6.3 years (ranges: 1 month to 19 years). There were 30 late deaths; the most frequent cause was myocardial infarction. Kaplan-Meier 5-year survival including perioperative deaths for all patients after the first operation was 76% and after the last operation 40%. We conclude that multiple aortic aneurysms can be safely managed, usually with staged repairs, and that long-term survival is probably. After the first aortic operation the presence of multiple aneurysms mandates close observation with timely surgical intervention.
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| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jan
|
| pubmed:issn |
0741-5214
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
11
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
19-27; discussion 27-8
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:2296101-Adult,
pubmed-meshheading:2296101-Aged,
pubmed-meshheading:2296101-Aortic Aneurysm,
pubmed-meshheading:2296101-Female,
pubmed-meshheading:2296101-Humans,
pubmed-meshheading:2296101-Male,
pubmed-meshheading:2296101-Middle Aged,
pubmed-meshheading:2296101-Morbidity,
pubmed-meshheading:2296101-Risk Factors
|
| pubmed:year |
1990
|
| pubmed:articleTitle |
Multiple aortic aneurysms: the results of surgical management.
|
| pubmed:affiliation |
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
|
| pubmed:publicationType |
Journal Article
|