Shota Yamanaka*, Haruo Aramoto, Go Urabe, Yoshihisa Makino and Tomoki Shimokawa
Department of Cardiovascular Surgery, Sakakibara Heart Institute, JapanFulltext PDF
Objectives: Early good outcomes of Endovascular Aneurysm Repair (EVAR) for Ruptured Abdominal Aortic Aneurysm (RAAA) have been reported. Even though EVAR for RAAA has the advantage of having low invasiveness, some disadvantages have been reported when it is compared to Open Repair (OR), which can be adapted to all cases. The aim of this study is to evaluate early and late outcomes of OR for RAAA in this endovascular era. Methods: Between September 2004 and October 2015, 150 consecutive patients with RAAA underwent OR in our institute. We performed left intercostal thoracotomy and descending aorta clamping for hemodynamic instability. The primary endpoints were early outcome, long-term survival, and aortic related re-intervention-free rate. Risk factors of 30-day mortality were defined by univariate and multivariate analysis. Results: The 30-day mortality was 15.3% (23/150). The cumulative five-year and ten-year survival rate were 66.2% and 50.7%, respectively. The cumulative five-year and ten-year freedom from aortic related re-intervention was 96.1% and 90.5%, respectively. Preoperative shock and Cardiopulmonary Resuscitation (CPR) were defined as risk factors of 30-day mortality. Conclusions: Early and late outcomes were satisfactory compared to other reports n the outcomes of OR (or) EVAR for RAAA. Controlling the preoperative shock state may improve early outcomes. In the ruptured cases, there were fewer aortic related re-interventions in OR than EVAR. It is essential to choose the optimal treatment based on the condition of RAAA in OR and EVAR. Keywords: Ruptured abdominal aortic aneurysm; Long-term survival; Open repair; Reintervention
Yamanaka S, Aramoto H, Urabe G, Makino Y, Shimokawa T. Early and Long-Term Outcome of 150 Consecutive Open Repairs for Ruptured Abdominal Aortic Aneurysms. Clin Surg. 2020; 5: 2896..