Aortobronchial and aortoesophageal fistulae as risk factors in surgery of descending thoracic aortic aneurysms.

Détails

ID Serval
serval:BIB_7476CD9FBC81
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Aortobronchial and aortoesophageal fistulae as risk factors in surgery of descending thoracic aortic aneurysms.
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
von Segesser L.K., Tkebuchava T., Niederhäuser U., Künzli A., Lachat M., Genoni M., Vogt P., Jenni R., Turina M.I.
ISSN
1010-7940
Statut éditorial
Publié
Date de publication
1997
Peer-reviewed
Oui
Volume
12
Numéro
2
Pages
195-201
Langue
anglais
Résumé
OBJECTIVE: Assess outcome of patients with descending thoracic aortic aneurysms complicated by aortobronchial and aortoesophageal fistulae in comparison to patients undergoing repair of aortic aneurysms without fistulae. METHODS: In a consecutive series of 145 patients (age 60 +/- 12 years) with repair of descending thoracic and thoracoabdominal aortic aneurysms, 11 patients (8%; age 63 +/- 9; NS) primarily presented for hematemesis and/or hemoptysis. In 8/11 patients (73%) an aortobronchial fistula was identified, and 3/11 patients (27%) suffered from an aortoesophageal fistula. Five of 11 patients (45%) had undergone previous aortic surgery in the same region. RESULTS: Extent of aortic segments (range 1-8) replaced was 3.1 +/- 1.4 for all versus 2.6 +/- 0.9 for fistulae (NS). Aortic cross clamp time was 38 +/- 22 min for all versus 45 +/- 15 min for fistulae (NS). Mortality at 30 days was 18/145 (12%) for all versus 16/134 (12%) without fistulae versus 2/11 (18%) with fistulae (NS). Paraparesis and or paraplegia was observed in 11/145 (8%) for all versus 10/134 (7%) without fistulae versus 1/11 (9%) for cases with fistulae (NS). Nine additional patients died after hospital discharge, seven without fistulae and two with fistulae (days 80, and 120) bringing the 1-year mortality up to 23/134 (17%) without fistulae versus 4/11 (36%) with fistulae (NS). Further analysis shows that the 1-year mortality accounts for 1/8 patients (13%) with aorto-bronchial fistulae versus to 3/3 patients (100%) with aorto-esophageal fistulae (esophageal versus bronchial fistula: P = 0.018; esophageal versus no fistula: P = 0.006). CONCLUSIONS: Outcome of patients suffering from descending thoracic aortic aneurysms complicated by aorto-bronchial fistulae can be similar to that without fistulae, whereas for cases complicated by aorto-esophageal fistulae the prognosis seems to remain poor even after successful hospital discharge.
Mots-clé
Aged, Analysis of Variance, Aortic Aneurysm, Thoracic, Aortic Diseases, Bronchial Fistula, Echocardiography, Esophageal Fistula, Female, Humans, Male, Middle Aged, Postoperative Complications, Probability, Prognosis, Risk Factors, Survival Rate, Tomography, X-Ray Computed
Pubmed
Web of science
Création de la notice
14/02/2008 15:16
Dernière modification de la notice
03/03/2018 18:21
Données d'usage