Clinical outcome of thoracoabdominal aortic aneurysm surgical repair : Preoperative predictors, intraoperative challenges, and postoperative sequels / Ahmed Abdalmoneim Mohammad ; Supervised Magdy Abdalwahhab Haggag , Karim Adel Hosny , Maher Abdalmoneim Mahdy

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of General Surgery

Introduction: TAAA represent 10% of thoracic aneurysms and 5% of all aortic aneurysms. TAAA open surgical repair is a challenging operation all over decades, as it conjugates the pathological comorbidities of AAA and surgical challenges of TAA, plus specific local and general operative impacts. Patients and methods: A prospective cohort study was carried out over 20 patients with TAAA of different Crawford extents, both males and females, and with different ages.The pre, intra, postoperative (for 3 months) data were collected and analyzed, as regard the preoperative comorbidities, aneurysmal disease facts, operative events, operative adjuncts, and postoperative sequels.The 1ry outcome parameters included operative related morbidities and mortality, and accordingly the patients were classified into bad outcome group and good outcome group. The 2ry outcome parameters included the risk factors or predictors of bad outcome group. Results: Chest morbidities were the most frequent postoperative complication scoring 35% of the studied cases, followed by cardiac morbidities affecting 30%, renal complications affecting 25%, mild superficial SSI affecting 25%, then MOSF affecting 10%, and paraplegia affecting 10% of cases. Early mortality that occurred within the 1st 3 weeks postoperatively scored 35% of the studied cases. The direct cause of mortality was cardiac insults in 43% of mortality cases, chest complications in 28.5%, and MOSF in 28.5% of them

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