Abstract
BackgroundEndovascular technology now permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results. The long-term durability of such stent grafts is unknown, leading to concerns regarding their use in younger patients. This study reports contemporary outcomes of open repair in young patients.MethodsOutcomes for patients age 60 or younger undergoing open TAAA repair between June 1999 and August 2013 with prospective collected data were analysed retrospectively.ResultsThirty-seven patients (31 men, 84%) with a median age of 56 (range 22–60) were identified with a median TAAA diameter of 6.9 cm (range 5.6-11). Aneurysm aetiology included degenerative change (18), dilation of chronic dissection (10), connective tissue disease (7) and mycotic degeneration (2). Crawford Type IV TAAA were most commonly treated (17), followed by Type II (10), Type III (7) and Type I (3). Two (5%) patients died in hospital, one from multiple organ failure and one from respiratory failure. Three patients (8%) developed temporary paraplegia, all of whom made a complete recovery and 4 (11%) patients required temporary renal replacement therapy. Median critical care stay was 5 days (range 2–28) with an in-hospital stay of 14 days (range 7–83). During a median follow-up of 72 months (range 13–171), no patient subsequently required any further aneurysm related surgical or radiological intervention. The mean (SEM) survival time was 138.5 (11) months. The 5 year survival was 79.7% (8.3) including early deaths, with no aneurysm related complications.ConclusionsThe outcome of open TAAA repair in patients aged less than 60 years is favorable. It is against these results that evolving endovascular interventions must be compared.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0195-4) contains supplementary material, which is available to authorized users.
Highlights
Endovascular technology permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results
We report our single centre experience of open repair in patients age 60 or under to allow comparison against emerging technologies
Thirty-seven patients (31 men, 84%) with a median age of 56 were identified with a median TAAA diameter of 6.9 cm (Figure 3). This represents 14% of all TAAA repairs performed by our unit over the 12 year time period
Summary
Endovascular technology permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results. The long-term durability of such stent grafts is unknown, leading to concerns regarding their use in younger patients. This study reports contemporary outcomes of open repair in young patients. The long-term durability of such stent grafts is, unknown, raising concerns regarding their use in younger patients. Endovascular enthusiasts measure their results against open surgical repair but little contemporary data are available reporting outcomes of open surgery in the younger patients. We report our single centre experience of open repair in patients age 60 or under to allow comparison against emerging technologies
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