Revision of the proximal aortic anastomosis after aortic bifurcation surgery

• Verfasst von: Kraus, Thomas W. [VerfasserIn]
• Verfasst von: Paetz, Burkhard [VerfasserIn]
• Verfasst von: Hupp, Thomas [VerfasserIn]
• Verfasst von: Allenberg, Jens-Rainer [VerfasserIn]
• Titel: Revision of the proximal aortic anastomosis after aortic bifurcation surgery
• Verf.angabe: Th. W. Kraus, B. Paetz, Th. Hupp, J.R. Allenberg
• Jahr: 1994
• Umfang: 6 S.
• Fussnoten: Elektronische Reproduktion der Druck-Ausgabe 15. Mai 2005 ; Gesehen am 18.09.2023
• Titel Quelle: Enthalten in: European journal of vascular surgery
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1987
• Jahr Quelle: 1994
• Band/Heft Quelle: 8(1994), 6, Seite 735-740
• ISSN Quelle: 1876-472X
• DOI: doi:10.1016/S0950-821X(05)80655-3
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aortic reoperative surgery
• Sach-SW: Bifurcation graft
• Sach-SW: Complication
• K10plus-PPN: 1859830471

Abstract

The implantation of an aortic bifurcation graft (ABG) for treatment of occlusive (OD) and aneurysmal (AD) aortoiliac disease is a standard technique with good long-term results and a relatively low incidence of complications. In a retrospective review of our patients from 1964 to 1993 only 36/1520 patients were identified who required reoperation at the proximal aortic anastomosis after ABG. Indications were graft occlusion (15/36) and graft stenoses (2/36), refractory to graft thrombectomy, proximal aortic anastomotic aneurysms (11/36) or graft infection (8/36). Graft occlusion or stenosis most frequently led to aortic reoperation in the OD-group (53.5%), recurrent aneurysmal disease (37.5%) and graft infection (37.5%) were the dominant indications in the AD-group. Mean time interval to reoperation was shorter in cases of graft infection (35 ± 33 months) as compared with graft stenosis (66 ±58 months), graft occlusion (86 ± 49 months) or aortic anastomotic aneurysms (152 ± 90 months). Of the reoperations, 92% were done electively, 8% as emergency procedures. The perioperative course was uneventful in 67% of patients. Overall mortality rate after elective revisional surgery was 3% but reached 66% in emergencies. Postoperative morbidity and mortality was related to preoperative morbidity and the urgency of surgery, not with the mode of aortic intervention nor indication.