1
|
Ilić N, Končar I, Dragaš M, Kostic D, Markovic M, Davidovic LB. Intercostal artery reimplantation: a double-edged sword. J Thorac Cardiovasc Surg 2013; 146:726-7. [PMID: 23953302 DOI: 10.1016/j.jtcvs.2013.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 04/14/2013] [Indexed: 11/29/2022]
|
2
|
Davidovic LB, Ilić N, Končar I, Dragaš M, Marković M, Sindjelic R, Savic N. Some technical considerations of open thoracoabdominal aortic aneurysm repair in a transition country. Vascular 2011; 19:333-7. [DOI: 10.1258/vasc.2010.oa0279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A variety of operative approaches and protective adjuncts have been used in thoracoabdominal aneurysm (TAA) repair to minimize the major complications of perioperative death and spinal cord ischemia. There is no consensus with respect to the optimal approach. We present 118 surgically treated patients over a 10-year period. The present study reviews our experience as a transition country (Serbia) in the treatment and problems we have encountered during open operative treatment of TAAs. Between 1999 and 2009, the authors reviewed 118 consecutive patients who underwent thoracoabdominal aortic resection using a variety of spinal cord protection. Clinical data collected prospectively were analyzed retrospectively. The purpose of the current study was to review the results of a large series of TAA repairs and to present some technical considerations and complications of open TAA repair. There were seven operative deaths (5.9%): two in the setting of ruptured TAAs, three myocardial infarctions and two due to hemorrhage. All 30 (25.4%) postoperative deaths occurred during the initial hospitalization. Postoperative complications included paraplegia in 11 patients (9.3%); renal failure in eight patients (6.8%), with four patients (3.4%) requiring hemodialysis; pulmonary complications in 75 patients (63.5%); bleeding requiring reoperation in two patients (1.7%) and coagulopathic hemorrhage in five patients (4.2%); cardiac complications in six patients (5.1%); stroke in five patients (4.2%); wound dehiscence in six patients (5.1%); and subdural hemorrhage in one patient (0.87%). Open TAA repair intrinsically has substantial complications, of which spinal cord ischemia and renal failure are the most devastating, despite major progress in our understanding of the pathophysiology and operative strategy. Our current review of data clearly proves that the surgical repair of TAAs remains a challenge even in the 21st century, especially in a country in transition.
Collapse
Affiliation(s)
- Lazar B Davidovic
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
- Medical Faculty, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Nikola Ilić
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
| | - Igor Končar
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
| | - Marko Dragaš
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
- Medical Faculty, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Miroslav Marković
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
- Medical Faculty, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Radomir Sindjelic
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
- Medical Faculty, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - Nebojsa Savic
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia
| |
Collapse
|