Clinical analysis of surgical treatment for 75 patients with thoracic aortic aneurysms

Objective To summarize the method and experience for the treatment of thoracic aortic aneurysms. Methods Clinical data of 75 patients with thoracic aortic aneurysms in the First Affiliated Hospital of Bengbu Medical College from September 2003 to October 2013 were retrospectively analyzed. Among them, 9 patients with acute Stanford type A aortic dissection, 3 patients with ascending aorta replacement and total aortic arch replacement, 6 patients of ascending aorta replacement and hemi-aortic arch replacement. In 26 patients for Stanford type B, there were 8 patients with artificial vascular replacement and 18 patients with endovascular graft exclusion. In 22 patients with rheumatic aortic lesions combined with expansion of the ascending aorta(ascending aorta diameter>5 cm), there were 13 patients with aortic dissection ascending aorta replacement and aortic valve replacement and 9 patients with the ascending aorta package and aortic valve replacement. Bentall surgery was performed for in 17 patients with marfan′s syndrome. Bentall surgery combined with bypass suregery from ascending aorta to bilateral femoral artery was conducted for 1 patient. Results The operation smoothly in all the patients, the operation time was 65-280 min, the average operative time was (166.5±76.7)min. The blocking time was 28-134 min. The average was (78.5±33.4)min. The selective cerebral perfusion time was 24-106 min. The average was (53.1±18.7)min. One patient died of postoperative bleeding and multiple organ failure. Two patients underwent the second operation for bleeding, postoperative pulmonary infection occurred in 3 patients, kidney failure in 2 patients, transient ventricalar tachycardia in one patient and refractory electrolyte disorder in one patient. Patients were well out of the hospital after treatment. There were no patients with endoleak and migration during treatment with endovascular graft exclusion. We followed-up 65 patients. The follow-up time was 6-110 months. The average was (50.2±10.8) months. During the following-up, one patient with inxestinal obstruction was cured, one patient died of cerebral in-farction. the others got satisfactory recovery and had a high qualily of life compared with the preoperation. Conclusions According to disease situation of patients, to select individualized treatment is the key to achieve good effect for thoracic aortic aneurysms patients. Key words: Aortic aneurysms, thoracic; Marfan syndrome; Surgical treatment; Individualized plan