Elective infrarenal abdominal aortic aneurysm repair - transperitoneal, retroperitoneal, endovascular?

• Published in: Interactive cardiovascular and thoracic surgery Vol. 9; no. 5; pp. 802 - 806
• Main Authors: Muehling, Bernd M, Orend, Karl Heinz, Sunder-Plassmann, Ludger
• Format: Journal Article
• Language: English
• Published: England Eur Assoc Cardio Surg 01.11.2009
• Subjects: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Blood Transfusion; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - mortality; Elective Surgical Procedures; Female; Hospital Mortality; Humans; Intensive Care Units; Length of Stay; Male; Middle Aged; Prosthesis Design; Prosthesis Failure; Reoperation; Retrospective Studies; Severity of Illness Index; Time Factors; Treatment Outcome; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - mortality
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2009.210039

Department of Thoracic and Vascular Surgery, University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany *Corresponding author. Tel.: +49-731-500-54044; fax: +49-731-500-26705. E-mail address : bernd.muehling{at}uniklinik-ulm.de (B.M. Muehling). We retrospectively analyzed the peri-operative outcome of 210 consecutive patients undergoing elective infrarenal abdominal aortic aneurysm (AAA) repair according to the surgical approach: transperitoneal (TP; 63 patients), retroperitoneal (RP; 81 patients) and endovascular (EV; 66 patients) repair. Concerning gender, AAA diameter and classification of the American Society of Anesthesiologists (ASA score) all groups were comparable; the median age in the EV group was significantly higher (78 years vs. 68 years and 67 years, respectively, P =0.001). Mortality rates were 0% for TP, 1.2% for RP and 3% for EV repair (n.s.). Morbidity rates did not significantly differ between the groups. In specialized centres mortality rates of elective infrarenal aneurysm repair are low – regardless of the surgical approach. In such centres the best treatment options for each patient as to the surgical approach as well as peri-operative management can be provided individually. Key Words: Aortic aneurysm; Elective repair; Transperitoneal; Retroperitoneal; Endovascular