Surgery for Acute Presentation of Thoracoabdominal Aortic Disease. Review uri icon

Overview

abstract

  • Thoracoabdominal aortic aneurysms are most commonly asymptomatic until there is either an impending aortic catastrophe or one that has already occurred. While open surgery remains the gold-standard method for repair, modern technology has led to the development of less invasive endovascular devices and techniques. We provide an expert review of open and endovascular therapies for 3 highly lethal thoracoabdominal aortic emergencies in order to highlight expectations for both short- and long-term outcomes in an era of evolving technology and improvements in patient evaluation and postoperative care. Open repair of ruptured thoracoabdominal aortic aneurysms is associated with a dramatic increase in all postoperative complications, even in specialized aortic surgery centers. Mycotic thoracic aortic aneurysms are highly lethal if surgical treatment is not initiated quickly as they have a propensity toward rapid growth and fatal rupture. Thoracic endovascular aortic repair is well-suited for the treatment of acute complicated type B aortic dissection with outcomes superior to open repair in some centers. Acute aortic events associated with thoracoabdominal aneurysms represent technically challenging situations that require rapid diagnosis and treatment to avoid a fatal outcome. Endovascular techniques have evolved as a viable alternative therapy for acute complicated type B aortic dissection or as a bridge to more definitive repair in the setting of infection or rupture.

publication date

  • July 30, 2018

Research

keywords

  • Aneurysm, Dissecting
  • Aneurysm, Infected
  • Aortic Aneurysm, Thoracic
  • Aortic Dissection
  • Aortic Rupture
  • Blood Vessel Prosthesis Implantation
  • Endovascular Procedures

Identity

Scopus Document Identifier

  • 85054143918

Digital Object Identifier (DOI)

  • 10.1053/j.semtcvs.2018.07.018

PubMed ID

  • 30071280

Additional Document Info

volume

  • 31

issue

  • 1