2007 Volume 16 Issue 1 Pages 13-16
Background: Rupture of thoracic aortic aneurysm is a lethal condition and its surgical outcome has been poor with high mortality and morbidity rates. This study was undertaken to assess retrospectively our surgical results for ruptured thoracic aortic aneurysms. Methods: This study includes 27 patients who underwent emergency operation for ruptured thoracic aortic aneurysm from 2001 to 2005 at our institution. Patients with acute aortic dissection and impending rupture of thoracic aortic aneurysm were excluded. The types of aneurysm were true in 20, false aneurysm in 2, and chronic aortic dissection in 5 patients (chronic type A dissection in 1, and chronic type B dissection in 4). The operative procedures were total arch replacement in 12, graft replacement of descending aorta in 9, hemiarch replacement in 1, graft replacement of thoracoabdominal aorta in 4, aortic root + hemiarch replacement in 1 patient. Results: There were 7 hospital deaths (25.9%), and the causes of death were low cardiac output in 2, cerebral infarction in 2, sepsis in 2, and lungs bleeding in 1 patient. Postoperative respiratory disorder was found in 5 (18.5%), and cerebral infarction in 8 (29.6%) patients. Predictive risk factor for hospital death was surgery through a left lateral thoracotomy. The risk factor for cerebral infarction was age more than 80 years. Postoperative survival rate at 3 years was 71.4% by the Kaplan-Meier method. Conclusion: The operative mortality of ruptured thoracic aortic aneurysm was still not unsatisfactory high. Prompt and adequate operative intervention without delay is required for the improvement of surgical outcome.
