Aortic aneurysms

rbccv Brazilian Journal of Cardiovascular Surgery Braz. J. Cardiovasc. Surg. 0102-7638 1678-9741 Sociedade Brasileira de Cirurgia Cardiovascular São Paulo, SP, Brazil Among 212 patients undergoing operation for aortic aneurysm and aortic dissection between January 1979 and January 1992, 97 were operated on for aneurysms. The aneurysms were localized in: ascending aorta in 46 patients, transverse aortic arch in 8, descending aorta in 8, thoracoabdominal aorta in 8, abdominal (infrarenal) aorta in 21, descending and abdominal aorta in 2, ascending and thoracoabdominal aorta in 2, ascending and descending in 1, ascending, transverse arch and descending aorta in 1. Hospital mortality was 14,4% being 27,7% (5/18) among patients over 70 years old an 11,3% (9/79) among patients under 70 years of age. Our experience suggests that: secondary and tertiary operations, advanced age, associated diseases, respiratory infection and acute renal failure increase early mortality. ARTIGOS ORIGINAIS Aneurismas da aorta Aortic aneurysms Januário M. Souza; Salomón O. Rojas; Marcos F. Berlinck; Ricardo Mazzieri; Paulo A. F Oliveira; José Renato M. Martins; Dante F. Senra; Valéria Salazar; Sérgio Almeida de Oliveira Do Serviço de Cirurgia Cardiovascular do Prof. Sérgio Almeida de Oliveira Endereço para separatas RESUMO Entre janeiro de 1979 e janeiro de 1992, foram realizadas 212 operações para correção de aneurismas e de dissecções da aorta. Neste trabalho serão analisados 104 procedimentos cirúrgicos (em 97 pacientes) para correção de aneurismas. A idade dos pacientes variou de 14 a 79 anos (média 59,5 anos) e o sexo predominante foi o masculino, com 75 pacientes. Os aneurismas localizavam-se na aorta ascendente em 46 pacientes, na croça em 8, na aorta descendente em 8, na aorta toráco-abdominal em 8, na aorta abdominal em 21, na aorta descendente e abdominal em 2, na aorta ascendente e tóraco-abdominal em 2, na aorta ascendente e descendente em 1, na aorta ascendente, croça e descendente em 1. Doenças cardiovasculares associadas estavam presentes em 39 pacientes, sendo valvopatia aórtica em 18 (excluídos os pacientes com ectasiaânulo-aórtíca), insuficiência coronária em 17, coarctação da aorta em 2, persistência do canal arterial em 1 e valvopatia mitral e aórtica em 1. A mortalidade imediata (hospitalar e/ou 30 dias) foi de 14,4%, sendo de 27,7% (5/18) para pacientes com mais de 70 anos e de 11,3% (9/79) para pacientes com idade inferior a 70 anos. Os aneurismas localizados na aorta ascendente e croça foram operados como o auxílio de circulação extracorpórea. Parada circulatória e hipotermia profunda foram utilizadas em todos os pacientes com aneurisma da croça. O estudo tomográfico e angiográfico deve ser de toda a aorta, pela possibilidade de aneurismas de localizações múltiplas. Descritores: aneurismas de aorta, cirurgia. ABSTRACT Among 212 patients undergoing operation for aortic aneurysm and aortic dissection between January 1979 and January 1992, 97 were operated on for aneurysms. The aneurysms were localized in: ascending aorta in 46 patients, transverse aortic arch in 8, descending aorta in 8, thoracoabdominal aorta in 8, abdominal (infrarenal) aorta in 21, descending and abdominal aorta in 2, ascending and thoracoabdominal aorta in 2, ascending and descending in 1, ascending, transverse arch and descending aorta in 1. Hospital mortality was 14,4% being 27,7% (5/18) among patients over 70 years old an 11,3% (9/79) among patients under 70 years of age. Our experience suggests that: secondary and tertiary operations, advanced age, associated diseases, respiratory infection and acute renal failure increase early mortality. Descriptors: aneurysms, aortic, surgery. Texto completo disponível apenas em PDF. Full text available only in PDF format. Endereço para separatas: Januário de Souza Rua Pará, 49 01243, São Paulo, SP, Brasil Trabalho realizado no Serviço de Cirurgia Cardiovascular do Prof. Dr. Sérgio Almeida de Oliveira. Hospital da Beneficência Portuguesa. São Paulo, SP, Brasil. Apresentado ao 19º Congresso Nacional de Cirurgia Cardíaca, São Paulo, SP, 7 a 9 de maio, 1992. 1 BENTALL, H. & De BONO, A. - A technique for complete replacement of the ascending aorta. Thorax, 23: 338-339, 1968. A technique for complete replacement of the ascending aorta Thorax 1968 338 339 23 BENTALL H De BONO A 2 BICKERSTAFF, L. K.; PAIROLERO, P. C.; HOLLIER, L. H.; MILTON, L. S.; VAN PEENEN, H. S.; CHERRY, K. S.; JOYCE, S. W.; LIE, I. 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