ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
A comparison between hiatal and thoracic clamping for ruptured abdominal aortic aneurysms
Yücel Özen, Sabit Sarikaya, Murat Bülent Rabuş, Ebuzer Aydın, Mehmet Dedemoğlu, Kaan Kırali
Department of Cardiovascular Surgery, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10593
Background: This study aims to evaluate the effects of hiatal and thoracic clamping on postoperative morbidity and mortality in the management of ruptured abdominal aortic aneurysms.

Methods: This retrospective study included 47 patients (35 males, 12 females) who were performed open repair for ruptured abdominal aortic aneurysms in our clinic between March 2005 and June 2013. Thoracic and hiatal clamping were performed in 26 (19 males, 7 females; mean age 68.5±8.0 years) and 21 (16 males, 5 females; mean age 66.1±7.8 years) patients, respectively. Postoperative complications and mortality were evaluated between the two groups by univariate and multivariate statistical analyses.

Results: Overall mortality was 36.7% (n=18) and there was no significant difference between the two groups. Univariate analyses showed no significant difference between the two groups in terms of postoperative respiratory complications (p=0.59), renal failure (p=0.98), the use of cell saver (p=0.26), and intestinal ischemia (p=0.08). Duration of hospital stay was longer in thoracic clamping group (p=0.01). Age and clamp time (>30 minutes) significantly increased hospital mortality.

Conclusion: Hiatal and thoracic clamping were not superior to each other when postoperative complications were compared in patients for whom infrarenal clamping was not feasible. Both techniques can be applied safely by keeping the cross-clamp time as short as possible.

Keywords : Abdominal aortic aneurysm; aortic aneurysm; aortic rupture; surgical clamp
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