Reconstructive aortic surgery in high-risk patients

Abstract

Background. The aim of this study is the presentation of proceeding method in high-risk patients qualified for reconstructive aortic surgery in abdominal segment. Retrospective evaluation of results was aimed at determining if the treatment algorithm developed in our Department allows for safe surgeries in high-risk patients.
Material and methods. The studied group consisted of patients who underwent surgery between 2001 and 2004, were over 80 years of age with/or ejection fraction below 45%, with/or I or II grade of chronic obturative pulmonary disease (COPD), with/or serum creatinine level over 3 mg%. Fifty seven patients (41 with AAA), including 6 with symptomatic AAA, and 16 with bilateral AIOD) were qualified for the study after analysis of clinical database. The control group consisted of the remaining patients who underwent aortic reconstruction in the same period, i.e. 165 patients with AAA, including 20 with symptomatic AAA, and 111 with AIOD (in total, 276 patients).
Results. It was found that the frequency of complications and mortality were not statistically different between the examined groups.
Conclusion. The results of surgical treatment can be no different from those obtained in the remaining patients in experienced, interdisciplinary team after application of certain proceeding algorithms, anticipation of possible complications and constant analysis of own behaviour.