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The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 50-54, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
V Pressler and JJ McNamara
In a 1980 review of the natural history and treatment of 176 thoracic
aortic aneurysms, we noted the high incidence of rupture (47% overall) in
135 patients not treated surgically. Since that original study we have
added another 84 patients to our series and have noted a complete change in
management such that most patients are now treated surgically. We now have
260 patients in our series, 126 of whom were treated surgically.
Sixty-seven were emergency operations and 59 were elective. Surgical
mortality was 8% for elective resection and 33% for emergency operation.
Over the past 5 years these figures have improved to 5% surgical mortality
for elective resection and 16% surgical mortality for emergency resection.
The 5 year survival rates for the entire series were 50% for patients
treated with elective operation, 30% for combined emergency and elective
operation groups, and 21% for nonsurgically treated patients. Abdominal
aortic aneurysm was present in 74 patients (28%) and 23 of these patients
had undergone a prior resection of an abdominal aortic aneurysm. This
series documents the improved survival of patients with aneurysms of the
thoracic aorta who are treated with prompt surgical intervention. It also
further substantiates earlier findings of a high incidence of aneurysms of
the abdominal aorta in this patient population.
ARTICLES
Aneurysm of the thoracic aorta. Review of 260 cases
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