ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgical repair of thoracoabdominal aortic aneurysms and dissections using the femoro-femoral distal perfusion technique
İlker Mataracı, Kaan Kırali, Murat Ökten, Mehmet Aksüt, Vedat Erentuğ, Mehmet Balkanay, Esat Akıncı, Cevat Yakut
Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Kliniği, İstanbul
Background: Ischemia of distal vital organs and reperfusion injury are the most important complications during surgical repair of thoracoabdominal aortic aneurysms and dissections. Distal femoro-femoral perfusion can reduce this risk in these patients. We evaluated the results of our patients operated on with this technique.

Methods: The study included 15 patients (12 males, 3 females; mean age 50±14 years; range 29 to 80 years) who underwent 17 operations using the femoro-femoral perfusion technique for the treatment of thoracoabdominal aortic aneurysms and dissections. Of these, 14 (82.4%) were elective, and three (17.6%) were emergency operations. While normal arterial and venous filling pressures were maintained in the proximal aorta, femoro-femoral perfusion was employed at 1000-1500 ml/min to keep the arterial pressure at 60-70 mmHg in the distal aorta. Rectal temperature was kept above 30 ºC. The mean follow-up was 3.5±1.9 years (range 0.8 to 6.8 years).

Results: Operative mortality occurred in four patients (23.5%) in the early postoperative period, being 66.7% in emergency cases and 14.3% in elective cases. Complications included respiratory problems (n=3, 17.6%), transient acute renal failure (n=3, 17.6%), paraplegia (n=1, 5.8), and temporary paraparesis (n=1, 5.8).

Conclusion: The use of the distal femoro-femoral perfusion technique to protect visceral organs and prevent spinal cord ischemia may decrease mortality and morbidity in patients undergoing surgery for thoracoabdominal aortic aneurysms and dissections.

Keywords : Anastomosis, surgical; aneurysm, dissecting/surgery; aortic aneurysm, abdominal/surgery; aortic aneurysm, thoracic/ surgery; perfusion; postoperative complications; spinal cord ischemia/ prevention & control
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