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5-year outcome after transcatheter aortic valve implantation.

https://arctichealth.org/en/permalink/ahliterature117830
Source
J Am Coll Cardiol. 2013 Jan 29;61(4):413-9
Publication Type
Article
Date
Jan-29-2013
Author
Stefan Toggweiler
Karin H Humphries
May Lee
Ronald K Binder
Robert R Moss
Melanie Freeman
Jian Ye
Anson Cheung
David A Wood
John G Webb
Author Affiliation
St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Source
J Am Coll Cardiol. 2013 Jan 29;61(4):413-9
Date
Jan-29-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Valve - physiopathology - surgery - ultrasonography
Aortic Valve Stenosis - diagnosis - epidemiology - physiopathology - surgery
Canada - epidemiology
Equipment Failure Analysis - statistics & numerical data
Female
Heart Valve Prosthesis Implantation - adverse effects - methods - mortality - statistics & numerical data
Humans
Male
Outcome and Process Assessment (Health Care)
Postoperative Period
Prognosis
Prosthesis Design
Prosthesis Failure - etiology
Risk factors
Severity of Illness Index
Survival Rate
Survivors - statistics & numerical data
Time Factors
Treatment Outcome
Abstract
The purpose of this study was to investigate the 5-year outcome following transcatheter aortic valve implantation (TAVI).
Little is known about long-term outcomes following TAVI.
The 5-year outcomes following successful TAVI with a balloon-expandable valve were evaluated in 88 patients. Patients who died within 30 days after TAVI were excluded.
Mean aortic valve gradient decreased from 46 ± 18 mm Hg to 10 ± 4.5 mm Hg after TAVI and 11.8 ± 5.7 mm Hg at 5 years (p for post-TAVI trend = 0.06). Mean aortic valve area increased from 0.62 ± 0.17 cm(2) to 1.67 ± 0.41 cm(2) after TAVI and 1.40 ± 0.25 cm(2) at 5 years (p for post-TAVI trend
PubMed ID
23265333 View in PubMed
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[Aortic valve replacement with stentless bioprosthesis].

https://arctichealth.org/en/permalink/ahliterature275350
Source
Khirurgiia (Mosk). 2016;(5):4-12
Publication Type
Article
Date
2016
Author
D A Astapov
D P Demidov
E I Semenova
Source
Khirurgiia (Mosk). 2016;(5):4-12
Date
2016
Language
Russian
Publication Type
Article
Keywords
Aged
Aortic Valve - surgery
Aortic Valve Stenosis - diagnosis - physiopathology - surgery
Bioprosthesis
Echocardiography - methods
Female
Heart Failure - diagnosis - etiology - physiopathology - prevention & control
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects - methods
Hemodynamics
Humans
Male
Operative Time
Postoperative Complications - diagnosis - physiopathology - prevention & control
Prospective Studies
Prosthesis Design - methods
Reproducibility of Results
Severity of Illness Index
Siberia
Suture Techniques
Treatment Outcome
Abstract
To evaluate prospectively the hemodynamic performance of «BioLAB Mono» stentless bioprosthesis implanted into aortic position.
Twenty seven patients (mean age 71 (67; 73); 17 women) with severe aortic stenosis underwent aortic valve replacement with «BioLAB Mono» stentless bioprosthesis from 2012 to 2014. The valves were implanted into supra-annular position using continuous polypropylene suture.
In the early postoperative period 1 patient (3.7%) died for acute heart failure. The mean aortic cross-clamping time was 81 (75; 90) min. Echocardiographic peak pressure gradient were 18 (16; 23) mmHg (postoperative). There were no cases of valve dysfunction in early postoperative period. Level of thrombocytes recovered after 10 days postoperatively.
«BioLAB Mono» aortic bioprosthesis implantation is easy and reproducible. The valve has excellent hemodynamic performance in early postoperative period.
PubMed ID
27271713 View in PubMed
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[Aortic valve replacement with stentless bioprosthesis: surgical technique and early outcomes].

https://arctichealth.org/en/permalink/ahliterature275339
Source
Khirurgiia (Mosk). 2016;(5):9-12
Publication Type
Article
Date
2016
Author
D A Astapov
D P Demidov
E I Demenova
Source
Khirurgiia (Mosk). 2016;(5):9-12
Date
2016
Language
Russian
Publication Type
Article
Keywords
Aged
Aortic Valve - surgery
Aortic Valve Stenosis - diagnosis - mortality - physiopathology - surgery
Bioprosthesis
Echocardiography - methods
Female
Heart Failure - diagnosis - etiology - physiopathology - prevention & control
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects - methods
Hemodynamics
Humans
Length of Stay
Male
Operative Time
Postoperative Complications - diagnosis - physiopathology - prevention & control
Prospective Studies
Severity of Illness Index
Siberia
Suture Techniques
Treatment Outcome
Abstract
To evaluate prospectively the hemodynamic performance of «BiolAB Mono» stentless bioprosthesis implanted into aortic position.
Twenty seven patients (mean age 71 (67; 73); 17 women) with severe aortic stenosis underwent, aortic valve replacement with «BioLAB Mono» stentless bioprosthesis from 2012 to 2014. The valves- were implanted into supraannular position using continuous polypropylene suture.
In the early postoperative period 1 patient (3.7%) died for acute heart failure. The mean aortic cross-clamping time was 81 (75; 90) min. Echocardiographic peak pressure gradient were 18 (16;23) mmHg (postoperative). There were no cases of valve dysfunction In early 'postoperative period. Level of thrombocytes recovered after 1 O days postoperatively.
«BioLAB Mono» aortic bioprosthesis implantation. is easy and reproducible. The valve has excellent hemodynamic performance ir;i early postoperative period.
PubMed ID
27447013 View in PubMed
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Blood transfusion and the risk of acute kidney injury after transcatheter aortic valve implantation.

https://arctichealth.org/en/permalink/ahliterature120012
Source
Circ Cardiovasc Interv. 2012 Oct;5(5):680-8
Publication Type
Article
Date
Oct-2012
Author
Rutger-Jan Nuis
Josep Rodés-Cabau
Jan-Malte Sinning
Leen van Garsse
Joelle Kefer
Johan Bosmans
Antonio E Dager
Nicolas van Mieghem
Marina Urena
Georg Nickenig
Nikos Werner
Jos Maessen
Parla Astarci
Sergio Perez
Luis M Benitez
Eric Dumont
Ron T van Domburg
Peter P de Jaegere
Author Affiliation
Department of Cardiology, ThoraxCenter, Erasmus Medical Center, Rotterdam, Netherlands.
Source
Circ Cardiovasc Interv. 2012 Oct;5(5):680-8
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - diagnosis - etiology - mortality - therapy
Aged
Aged, 80 and over
Aortic Valve Stenosis - mortality - therapy
Blood Transfusion - adverse effects - mortality
Cardiac Catheterization - adverse effects - mortality
Chi-Square Distribution
Colombia
Comorbidity
Europe
Female
Heart Valve Prosthesis Implantation - adverse effects - methods - mortality
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Odds Ratio
Proportional Hazards Models
Quebec
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Blood transfusion is associated with acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI). We sought to elucidate in more detail the relation between blood transfusion and AKI and its effects on short- and long-term mortality.
Nine hundred ninety-five patients with aortic stenosis underwent TAVI with the Medtronic CoreValve or the Edwards Valve in 7 centers. AKI was defined by the Valve Academic Research Consortium (absolute increase in serum creatinine =0.3 mg/dL [=26.4 µmol/L] or =50% increase =72 hours). Logistic and Cox regression was used for predictor and survival analysis. AKI occurred in 20.7% (n=206). The number of units of blood transfusion =24 hours was the strongest predictor of AKI (=5 units, OR, 4.81 [1.45-15.95], 3-4 units, OR, 3.05 [1.24-7.53], 1-2 units, OR, 1.47 [0.98-2.22]) followed by peripheral vascular disease (OR, 1.48 [1.05-2.10]), history of heart failure (OR, 1.43 [1.01-2.03]), leucocyte count =72 hours after TAVI (OR, 1.05 [1.02-1.09]) and European System for Cardiac Operative Risk Evaluation (EuroSCORE; OR, 1.02 [1.00-1.03]). Potential triggers of blood transfusion such as baseline anemia, bleeding-vascular complications, and perioperative blood loss were not identified as predictors. AKI and life-threatening bleeding were independent predictors of 30-day mortality (OR, 3.15 [1.56-6.38], OR, 6.65 [2.28-19.44], respectively), whereas transfusion (=3 units), baseline anemia, and AKI predicted mortality beyond 30 days.
AKI occurred in 21% of the patients after TAVI. The number of blood transfusions but not the indication of transfusion predicted AKI. AKI was a predictor of both short- and long-term mortality, whereas blood transfusion predicted long-term mortality. These findings indicate that outcome of TAVI may be improved by more restrictive use of blood transfusions.
Notes
Erratum In: Circ Cardiovasc Interv. 2012 Dec;5(6):e89
PubMed ID
23048055 View in PubMed
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Canadian experience with percutaneous endovascular aneurysm repair: short-term outcomes.

https://arctichealth.org/en/permalink/ahliterature147676
Source
Can J Surg. 2009 Oct;52(5):E156-60
Publication Type
Article
Date
Oct-2009
Author
S Marlene Grenon
Joel Gagnon
York N Hsiang
Jerry C Chen
Author Affiliation
Division of Vascular Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC.
Source
Can J Surg. 2009 Oct;52(5):E156-60
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Angiography - methods
Angioplasty - methods
Aortic Aneurysm, Abdominal - physiopathology - radiography - surgery
Blood Vessel Prosthesis Implantation - adverse effects - methods
British Columbia
Cohort Studies
Female
Follow-Up Studies
Hospitals, Teaching
Hospitals, University
Humans
Iliac Artery - surgery
Length of Stay
Male
Postoperative Complications - epidemiology - physiopathology
Prosthesis Failure
Retrospective Studies
Risk assessment
Severity of Illness Index
Surgical Procedures, Elective
Treatment Outcome
Vascular Surgical Procedures - adverse effects - methods
Abstract
To decrease the morbidity associated with cut-downs during endovascular aneurysm repair, some authors have suggested the totally percutaneous endovascular repair (PEVAR). The goal of this report is to evaluate and describe our centre's experience with the total percutaneous endovascular aneurysm repair (PEVAR) for aortic abdominal aneurysm (AAA).
We performed a retrospective analysis of 15 consecutive patients with AAA, including 1 with right common iliac artery aneurysm.
There were 12 men and 3 women with a mean age of 74 (standard deviation [SD] 2) years who underwent PEVAR with a Perclose ProGlide suture-mediated closure system between July 2007 and July 2008. All surgeries were elective. Forty percent of patients had a history of smoking, 73% were hypertensive, 33% were diabetic, 20% had chronic obstructive pulmonary disease and 40% had coronary artery disease. Fourteen patients had bilateral deployment for bifurcated devices (7 bifurcated Gore Excluder, 7 bifurcated Cook Zenith grafts), and 1 patient had unilateral deployment for a Cook Zenith device. The outer diameter of the sheaths used for puncture sites was on average 18.1-Fr (SD 0.6), with main bodies being 21.1-Fr (SD 0.3) and contralateral sides 15-Fr (SD 0.3). Procedural success was 93%, with 1 patient requiring a femoral artery cut-down because of failure of the Perclose device to deploy in the groin. Another patient had persistent venous bleeding in 1 puncture site that stopped with skin suturing. Endovascular aneurysm repair was 100% with no conversion to open surgery and no type-I endoleaks. The mean length of stay in hospital was 2.2 (SD 0.4) days. There were no long-term groin complications at 6 (SD 1) months' follow-up.
To our knowledge, this is the first Canadian report of experience with PEVAR using the Perclose device. The technique is safe, reliable and allows discharge of patients soon after surgery.
Notes
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PubMed ID
19865546 View in PubMed
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[Cardiorenal prognosis in kidney dysfunction patients undergoing cardiac surgery].

https://arctichealth.org/en/permalink/ahliterature270165
Source
Ter Arkh. 2015;87(9):58-63
Publication Type
Article
Date
2015
Author
B G Iskenderov
O N Sisina
Source
Ter Arkh. 2015;87(9):58-63
Date
2015
Language
Russian
Publication Type
Article
Keywords
Aged
Coronary Artery Bypass - adverse effects - methods - statistics & numerical data
Female
Glomerular Filtration Rate
Heart Diseases - classification - complications - epidemiology - surgery
Heart Valve Prosthesis Implantation - adverse effects - methods - statistics & numerical data
Humans
Male
Middle Aged
Postoperative Complications - diagnosis - epidemiology
Prognosis
Renal Dialysis - methods - statistics & numerical data
Renal Insufficiency, Chronic - complications - diagnosis - epidemiology - therapy
Risk factors
Russia - epidemiology
Severity of Illness Index
Abstract
To evaluate the impact of cardiac surgical procedures on cardiac and renal functions within 12 months after surgery in patients with a history of chronic kidney disease (CKD).
A total of 875 patients (464 men and 411 women) aged 32 to 68 years (62.3±5.2 years), including 396 patients who had undergone heart valve replacement under extracorporeal circulation, 422 who had aortocoronary and/or mammary coronary artery bypass, and 57 who had a combination of these operations, were examined. According to the baseline glomerular filtration rate (GFR), the patients were divided into 2 groups: 1) 508 patients with preserved kidney function (GFR, higher than 90 ml/min/1.73 m2); 2) 367 with CKD (GFR, 89 to 60 ml/min/1.73 m2). Results. In Group 2, early postoperative cardiovascular events were noted significantly more frequently and mortality proved to be higher than in Group 1. By the end of the first year of a follow-up, CKD was diagnosed in 5.4% of the patients in Group 1. In Group 2, CKD regressed in 54.1 % of the patients and, on the contrary, progressed in 9.5%. In Group 2, programmed hemodialysis was performed in 15 (4.4%) patients. Overall mortality was significantly higher in patients with a postoperative glomerular filtration fall in both Groups 1 and 2 (7.5 and 8.4%, respectively). Long-term cardiovascular events were significantly more common in patients with progressive CKD and postoperative kidney dysfunction.
A slight decrease in glomerular filtration makes the immediate prognosis of cardiac surgery poorer. The late cardiorenal prognosis mainly depends on changes in kidney function; regression of CKD is noted in 50% of the cases.
PubMed ID
26591554 View in PubMed
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Cerebral embolism following transcatheter aortic valve implantation: comparison of transfemoral and transapical approaches.

https://arctichealth.org/en/permalink/ahliterature138367
Source
J Am Coll Cardiol. 2011 Jan 4;57(1):18-28
Publication Type
Article
Date
Jan-4-2011
Author
Josep Rodés-Cabau
Eric Dumont
Robert H Boone
Eric Larose
Rodrigo Bagur
Ronen Gurvitch
Fernand Bédard
Daniel Doyle
Robert De Larochellière
Cleonie Jayasuria
Jacques Villeneuve
Alier Marrero
Mélanie Côté
Philippe Pibarot
John G Webb
Author Affiliation
Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. josep.rodes@criucpq.ulaval.ca
Source
J Am Coll Cardiol. 2011 Jan 4;57(1):18-28
Date
Jan-4-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Aorta, Thoracic
Aortic Valve Stenosis - diagnosis - surgery
British Columbia - epidemiology
Cardiac Catheterization - adverse effects
Diffusion Magnetic Resonance Imaging
Echocardiography, Transesophageal
Female
Femoral Artery
Follow-Up Studies
Heart Valve Prosthesis Implantation - adverse effects - methods
Humans
Incidence
Intracranial Embolism - diagnosis - epidemiology - etiology
Male
Prospective Studies
Quebec - epidemiology
Risk factors
Tomography, X-Ray Computed
Abstract
The objective of this study was to compare the incidence of cerebral embolism (CE) as evaluated by diffusion-weighted magnetic resonance imaging (DW-MRI) following transapical (TA) transcatheter aortic valve implantation (TAVI) versus transfemoral (TF) TAVI.
The TA-TAVI approach avoids both the manipulation of large catheters in the aortic arch/ascending aorta and the retrograde crossing of the aortic valve, and this avoidance might lead to a lower rate of CE.
This was a prospective multicenter study including 60 patients who underwent cerebral DW-MRI the day before and within the 6 days following TAVI (TF approach: 29 patients; TA approach: 31 patients). Neurologic and cognitive function assessments were performed at DW-MRI time points.
The TAVI procedure was performed with the Edwards valve and was successful in all cases but one (98%). A total of 41 patients (68%) had 251 new cerebral ischemic lesions at the DW-MRI performed 4 ± 1 days after the procedure, 19 patients in the TF group (66%) and 22 patients in the TA group (71%; p = 0.78). Most patients (76%) with new ischemic lesions had multiple lesions (median number of lesions per patient: 3, range 1 to 31). There were no differences in lesion number and size between the TF and TA groups. No baseline or procedural factors were found to be predictors of new ischemic lesions. The occurrence of CE was not associated with a measurable impairment in cognitive function, but 2 patients (3.3%) had a clinically apparent stroke within the 24 h following the procedure (1 patient in each group).
TAVI is associated with a high rate of silent cerebral ischemic lesions as evaluated by DW-MRI, with no differences between the TF and TA approaches. These results provide important novel insight into the mechanisms of CE associated with TAVI and support the need for further research to both reduce the incidence of CE during these procedures and better determine their clinical relevance.
Notes
Comment In: Nat Rev Cardiol. 2011 Mar;8(3):12021475318
PubMed ID
21185496 View in PubMed
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Contemporary trends in aortic valve surgery: a single centre 10-year clinical experience.

https://arctichealth.org/en/permalink/ahliterature177388
Source
J Card Surg. 2004 Nov-Dec;19(6):552-8
Publication Type
Article
Author
Naoji Hanayama
Shafie Fazel
Bernard S Goldman
Peter R Mitoff
Jeri Sever
Stephen E Fremes
Author Affiliation
Division of Cardiovascular Surgery, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Source
J Card Surg. 2004 Nov-Dec;19(6):552-8
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Valve - surgery
Blood Vessel Prosthesis Implantation
Canada - epidemiology
Coronary Artery Bypass
Female
Follow-Up Studies
Heart Valve Diseases - surgery
Heart Valve Prosthesis Implantation - adverse effects - methods
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Predictive value of tests
Prospective Studies
Risk factors
Stents
Survival Analysis
Time Factors
Treatment Outcome
Abstract
The purpose of this study is to present a comprehensive profile of the trends in aortic valve replacement at a single institution over the past decade. Prospectively collected data concerning 873 patients undergoing aortic valve replacement (AVR), with and without coronary artery bypass grafting (CABG), were analysed. The patients were divided into three time periods: period I, (1990 to 1993); period II, (1994 to 1996); and period III, (1997 to 2000). Actuarial survival of AVR patients with and without CABG at 7 years was 82.9 +/- 2.4% and 79.1 +/- 3.3% (p = 0.17), respectively. Actuarial survival at 7 years for stentless, mechanical, and stented valve patients were 89.5 +/- 2.7%, 85.5 +/- 2.8%, and 76.0 +/- 3.2%, respectively. There was a significant difference in survival between the stentless and stented valve groups (p = 0.014). Age (63.8 +/- 12.9 yrs, 66.2 +/- 11.0 yrs, 67.9 +/- 10.3 yrs; p = 0.01), the incidence of peripheral vascular disease (5.1%, 10.8%, 16.6%; p = 0.001), and the extent of coronary artery disease necessitating CABG (34.0%, 38.8%, 41.0%; p = 0.05) have increased significantly in the later time period. However, operative mortality has remained constant (4.7%, 4.8%, 4.5%; p = 0.9). Moreover, perioperative complications have decreased significantly (27.4%, 18.0, 16.0%; p = 0.001). Multivariate analysis identified more recent time period as independent protective factor for early mortality and morbidity (period I, RR 1.00; period II, RR 0.47; period III, RR 0.40).
PubMed ID
15548192 View in PubMed
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Discomfort five years after laparoscopic and Shouldice inguinal hernia repair: a randomised trial with 867 patients. A report from the SMIL study group.

https://arctichealth.org/en/permalink/ahliterature164095
Source
Hernia. 2007 Aug;11(4):307-13
Publication Type
Article
Date
Aug-2007
Author
Fritz H Berndsen
U. Petersson
D. Arvidsson
C-E Leijonmarck
C. Rudberg
S. Smedberg
A. Montgomery
Author Affiliation
Department of Surgery, Akranes Hospital, 300 Akranes, Iceland. fritz.berndsen@simnet.is
Source
Hernia. 2007 Aug;11(4):307-13
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Follow-Up Studies
Hernia, Inguinal - psychology - surgery
Humans
Incidence
Laparoscopy - adverse effects - methods
Male
Middle Aged
Pain Measurement
Pain, Postoperative - diagnosis - epidemiology - etiology
Patient satisfaction
Prosthesis Implantation - adverse effects - methods
Questionnaires
Recurrence
Retrospective Studies
Surgical Mesh
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
In recent years long-term discomfort after inguinal hernia surgery has become an issue of great concern to hernia surgeons. Long-term results on discomfort from large randomised studies are sparse.
One-thousand one-hundred and eighty-three patients were randomised in a multicentre trial with the primary aim of comparing recurrence rates after laparoscopic TAPP and Shouldice repair. Evaluating late discomfort and its possible risk factors were secondary objectives, and are reported here. The patients were clinically examined after 1 and 5 years, and answered questionnaires 2 and 3 years postoperation.
Of 1,068 operated patients, 867 were eligible for analysis after 5 years (81.2%). The percentage of patients experiencing discomfort of any kind were 8.5% in the TAPP group and 11.4% (p = 0.156) in the Shouldice group. Although discomfort was usually mild it was severe for 0.2 and 0.7%, respectively. Severe pain the first postoperative week was a risk factor for late discomfort in the Shouldice group (OR 2.25, P = 0.022) but not in the TAPP group. No other risk factor for late discomfort was found.
There was no difference between late discomfort at five-year follow-up after laparoscopic TAPP and Shouldice repair. Discomfort was mostly mild and pain during the first postoperative week was a prognostic variable for late discomfort in Shouldice patients.
Notes
Comment In: Hernia. 2008 Aug;12(4):445-618270787
PubMed ID
17440795 View in PubMed
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Editor's Choice - Abdominal Compartment Syndrome after Surgery for Abdominal Aortic Aneurysm: Subgroups, Risk Factors, and Outcome.

https://arctichealth.org/en/permalink/ahliterature310106
Source
Eur J Vasc Endovasc Surg. 2019 Nov; 58(5):671-679
Publication Type
Journal Article
Date
Nov-2019
Author
Samuel Ersryd
Khatereh Djavani Gidlund
Anders Wanhainen
Linn Smith
Martin Björck
Author Affiliation
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden. Electronic address: samuel.ersryd@regiongavleborg.se.
Source
Eur J Vasc Endovasc Surg. 2019 Nov; 58(5):671-679
Date
Nov-2019
Language
English
Publication Type
Journal Article
Keywords
Aged
Aortic Aneurysm, Abdominal - complications - surgery
Aortic Rupture - etiology - surgery
Blood Vessel Prosthesis Implantation - adverse effects - methods
Decompression, Surgical - methods - statistics & numerical data
Early Diagnosis
Endovascular Procedures - adverse effects - methods
Female
Humans
Intra-Abdominal Hypertension - etiology - mortality - physiopathology - surgery
Laparotomy - methods - statistics & numerical data
Male
Outcome and Process Assessment, Health Care
Postoperative Complications - diagnosis - mortality - physiopathology - surgery
Renal Replacement Therapy - statistics & numerical data
Reoperation - methods - statistics & numerical data
Risk assessment
Sweden
Abstract
Abdominal compartment syndrome (ACS) is a serious complication after abdominal aortic aneurysm (AAA) repair. The aim was to investigate outcome among subgroups and factors associated with outcome, with emphasis on the duration of intra-abdominal hypertension before treatment.
Since 2008, ACS and decompressive laparotomy (DL) after AAA repair are registered prospectively in the Swedish vascular registry (Swedvasc). Registry data and case records were reviewed. Subgroups were defined by main pathophysiological finding at DL, timing of DL after AAA repair, and treatment modality.
During 2008-2015, 120 of 8765 patients undergoing surgery for infrarenal AAA developed post-operative ACS (1.4%). Eighty-three followed ruptured AAA (rAAA); 45 open surgical repairs (OSR) and 38 endovascular (EVAR), and thirty-seven after intact AAA (iAAA); 30 OSR and seven EVAR. The main pathophysiological findings at DL were bowel ischaemia in 27 (23.3%), post-operative bleeding in 34 (29.3%), and general oedema in 55 (47.4%). DL was performed 48 hours in 29 patients (25.2%). The overall 90 day mortality was 50.0%, neither different depending on main pathophysiological finding, nor on the timing of DL. In multivariable regression analysis, age was a predictor of mortality (p = .017), while duration of intra-abdominal hypertension (IAH) prior to DL predicted the need for renal replacement therapy (RRT) (p = .033). DL was performed earlier after EVAR compared with OSR in rAAA (p 
Notes
CommentIn: Eur J Vasc Endovasc Surg. 2019 Nov;58(5):680 PMID 31202579
PubMed ID
31405726 View in PubMed
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38 records – page 1 of 4.