HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moreno-Cabral, C. E. Articles by Shumway, N. E. Search for Related Content PubMed PubMed Citation Articles by Moreno-Cabral, C. E. Articles by Shumway, N. E.

The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 1020-1032, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Degenerative and atherosclerotic aneurysms of the thoracic aorta. Determinants of early and late surgical outcome

CE Moreno-Cabral, DC Miller, RS Mitchell, EB Stinson, PE Oyer, SW Jamieson and NE Shumway

To identify significant predictors of early and late mortality, multivariate discriminant analyses were applied to the clinical outcome of 175 consecutive patients with thoracic aortic aneurysms operated upon over a 20 year span. Only atherosclerotic and degenerative aneurysms were included; the patients were segregated into two groups according to location of the aneurysm. The ascending aortic aneurysm group consisted of 124 patients, 85% of whom required concomitant aortic valve replacement. There were 51 patients in the descending aortic aneurysm group. Mean follow-up was 4.9 years (maximum of 19 years), with a total of 860 patient-years of follow-up. Multivariate analyses revealed that surgical priority and advanced age were independent determinants of hospital mortality in the ascending group; for the descending group, surgical priority and the presence of congestive heart failure were the strongest predictors of hospital mortality. Late mortality in the ascending group correlated with advanced age. Hypertension and the presence of preoperative congestive heart failure were independent determinants of late mortality in the descending group. Several variables did not have any independent bearing on hospital or late mortality, including etiology and location of the aneurysm, previous myocardial infarction, chronic lung disease, and concomitant aortic valve replacement. High-risk subgroups of patients with thoracic aortic aneurysms can be identified by these variables. Aggressive medical plus surgical management and operation prior to aneurysm rupture is necessary to improve both early and long- term survival rates.

This article has been cited by other articles:

				N. T. Kouchoukos Letter Regarding Article by Katzen et al, "Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms" Circulation, April 4, 2006; 113(13): e676 - e676. [Full Text] [PDF]

				Y.-C. Weon, S.-G. Kang, J. W. Chung, Y. I. Kim, J. H. Park, and D. Y. Lee Technical feasibility and biocompatibility of a newly designed separating stent-graft in the normal canine aorta. Am. J. Roentgenol., April 1, 2006; 186(4): 1148 - 1154. [Abstract] [Full Text] [PDF]

				B. T. Katzen, M. D. Dake, A. A. MacLean, and D. S. Wang Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms Circulation, September 13, 2005; 112(11): 1663 - 1675. [Full Text] [PDF]

				J. Akasaka, K. Tabayashi, Y. Saiki, K. Oda, K. Kumagai, and A. Iguchi Stent grafting technique using Matsui-Kitamura (MK) stent for patients with aortic arch aneurysm Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 649 - 653. [Abstract] [Full Text] [PDF]

				J. S. Ikonomidis, W. C. Gibson, J. E. Butler, D. M. McClister, S. E. Sweterlitsch, R. P. Thompson, R. Mukherjee, and F. G. Spinale Effects of Deletion of the Tissue Inhibitor of Matrix Metalloproteinases-1 Gene on the Progression of Murine Thoracic Aortic Aneurysms Circulation, September 14, 2004; 110(11_suppl_1): II-268 - II-273. [Abstract] [Full Text] [PDF]

				P. Demers, D. C. Miller, R. S. Mitchell, S. T. Kee, D. Sze, M. K. Razavi, and M. D. Dake Midterm results of endovascular repair of descending thoracic aortic aneurysms with first-generation stent grafts J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 664 - 673. [Abstract] [Full Text] [PDF]

				B. V. Czermak, P. Waldenberger, R. Perkmann, M. Rieger, I. E. Steingruber, A. Mallouhi, G. Fraedrich, and W. R. Jaschke Placement of Endovascular Stent-Grafts for Emergency Treatment of Acute Disease of the Descending Thoracic Aorta Am. J. Roentgenol., August 1, 2002; 179(2): 337 - 345. [Abstract] [Full Text] [PDF]

				P. Alric and C. H. Marty-Ane Endovascular treatment of ruptured thoracic aortic aneurysms J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 180 - 182. [Full Text] [PDF]

				E. S. Rachel, T. M. Bergamini, E. V. Kinney, M. T. Jung, H. W. Kaebnick, and R. A. Mitchell Endovascular Repair of Thoracic Aortic Aneurysms: A Paradigm Shift in Standard of Care Vascular and Endovascular Surgery, March 1, 2002; 36(2): 105 - 113. [Abstract] [PDF]

				T. Resch, B. Koul, N. V. Dias, B. Lindblad, and K. Ivancev Changes in aneurysm morphology and stent-graft configuration after endovascular repair of aneurysms of the descending thoracic aorta J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 47 - 52. [Abstract] [Full Text] [PDF]

				K. Inoue, H. Hosokawa, T. Iwase, M. Sato, Y. Yoshida, K. Ueno, A. Tsubokawa, T. Tanaka, S. Tamaki, and T. Suzuki Aortic Arch Reconstruction by Transluminally Placed Endovascular Branched Stent Graft Circulation, November 9, 1999; 100(90002): II-316 - 321. [Abstract] [Full Text] [PDF]

				Y. Moriyama, R. Toda, K. Hisatomi, H. Matsumoto, and A. Taira EXTRAPLEURAL APPROACH IN THE MANAGEMENT OF THE DESCENDING THORACIC AORTIC ANEURYSM WITH DENSE LUNG ADHESION J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 746 - 747. [Full Text] [PDF]

				C. R. Smith and T. B. Spanier Aprotinin in deep hypothermic circulatory arrest Ann. Thorac. Surg., July 1, 1999; 68(1): 278 - 286. [Abstract] [Full Text] [PDF]

				M. Ehrlich, M. Grabenwoeger, F. Cartes-Zumelzu, M. Grimm, D. Petzl, J. Lammer, S. Thurnher, E. Wolner, and M. Havel Endovascular stent graft repair for aneurysms on the descending thoracic aorta Ann. Thorac. Surg., July 1, 1998; 66(1): 19 - 24. [Abstract] [Full Text] [PDF]

				R. S. Mitchell, M. D. Dake, C. P. Semba, T. J. Fogarty, C. K. Zarins, R. P. Liddell, and D. C. Miller ENDOVASCULAR STENT-GRAFT REPAIR OF THORACIC AORTIC ANEURYSMS J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1054 - 1062. [Abstract] [Full Text]

				M. D. Dake, D. C. Miller, C. P. Semba, R. S. Mitchell, P. J. Walker, and R. P. Liddell Transluminal Placement of Endovascular Stent-Grafts for the Treatment of Descending Thoracic Aortic Aneurysms N. Engl. J. Med., December 29, 1994; 331(26): 1729 - 1734. [Abstract] [Full Text]

				M. A. Ergin, J. D. Galla, S. L. Lansman, C. Quintana, C. Bodian, and R. B. Griepp Hypothermic circulatory arrest in operations on the thoracic aortaDeterminants of operative mortality and neurologic outcome J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 788 - 799. [Abstract] [Full Text]