The Annals of Thoracic Surgery, Vol 39, 47-52, Copyright © 1985 by The Society of Thoracic Surgeons
Rigid intraluminal prosthesis for replacement of thoracic and abdominal aorta
PM Spagna, GM Lemole, MD Strong and NP Karmilowicz
During the past seven years, 80 patients have undergone aortic substitution
using a rigid intraluminal prosthesis. There were 9 early deaths. The
procedures involved 32 dissecting aneurysms (18 ascending and 14
descending), 16 atherosclerotic aneurysms of the ascending aorta and 13
atherosclerotic aneurysms of the descending aorta, 3 thoracoabdominal
aneurysms, 2 arch aneurysms, and 14 abdominal aortic aneurysms. There was
one early dislodgment of the rings necessitating reoperation, but no other
early complications related to the procedure. In the follow-up period
(mean, 25 months) there were 6 late deaths. One occurred 6 months after
operation in a patient with empyema. There were no late complications of
thrombosis, erosion, pseudoaneurysm formation, or hemorrhage. The follow-up
data are extremely encouraging. We now are using this device whenever
possible in all substitutions of the aorta, although in approximately 40%
of patients, it is necessary to remove one of the spools and suture either
the proximal or distal end of the graft owing to the close proximity of the
aneurysm to the coronary ostia or the origin of the subclavian artery.
Important techniques of insertion and postoperative angiograms are
presented.
