Resultados del tratamiento quirúrgico de la oclusión aguda de aorta abdominal / Outcomes after treatment of acute aortic occlusion

INTRODUCCIÓN: La oclusión aórtica aguda (OAA) es una patología infrecuente con una alta morbimortalidad. El objetivo del estudio fue describir los resultados del tratamiento quirúrgico de la oclusión aórtica aguda y factores de riesgo de mortalidad. MÉTODOS: Se revisaron retrospectivamente las historias clínicas de 29 pacientes diagnosticados e intervenidos por OAA durante 28 años. Se recogieron las variables edad, sexo, tabaco, diabetes, insuficiencia renal crónica, insuficiencia cardiaca, fibrilación auricular, hipertensión arterial, síntomas, diagnóstico y tratamiento, mortalidad a 30 días y supervivencia a largo plazo. Se analizó mediante análisis univariante que factores se relacionaban con la mortalidad. RESULTADOS: Se incluyeron 29 (18 varones), con una media de 66,2 años. La etiología fue: embolia (EM) en 11 casos y trombosis (TR) en 18 casos. Los procedimientos quirúrgicos realizados incluyeron trombectomía transfemoral bilateral (14 casos), by-pass aorto bifemoral (8 casos), by-pass axilo uni/bifemoral (5 casos) y tromboendarterectomía aortoiliaca y renal (2 casos). La morbilidad incluyó: insuficiencia renal (14 casos), isquemia mesentérica (4 casos), complicaciones cardiacas (7 casos), complicaciones respiratorias (5 casos) y pérdida de la extremidad (2 casos). La mortalidad hospitalaria fue del 21% (EM 0%, TR 21%). La supervivencia estimada a 1, 3 y 5 años fue del 60, 50 y 44% respectivamente. La edad (p = 0,032), la hipertensión arterial (p = 0,039) y la etiología de la OAA (p = 0,039) se relacionaron con la mortalidad. CONCLUSIONES: La oclusión aguda de aorta abdominal constituye una urgencia médica con elevada mortalidad. siendo la insuficiencia renal aguda la complicación más frecuente en el postoperatorio

INTRODUCTION: Acute aortic occlusion (AAO) is a rare disease with high morbidity and mortality. The aim of this study was to describe the results of surgical treatment of acute aortic occlusion and risk factors for mortality. METHODS: Retrospective review of the clinical history of 29 patients diagnosed and operated on for AAO during 28 years. The following variables were analysed: age, sex, tabaco use, diabetes, chronic renal insufficiency, chronic heart failure, atrial fibrillation, arterial hypertension, symptoms, diagnosis and treatment, 30-day mortality and long-term survival. A univariant analysis was performed of variables related to mortality. RESULTS: Twenty-nine patients were included (18 male) with a mean age of 66,2 years. The aetiology was: embolism (EM) in 11 cases and Thrombosis (TR) in 18 cases. The surgical procedures performed included bilateral transfemoral thrombectomy (14 cases), aortobifemoral by-pass (8 cases), axilo uni/bifemoral by-pass (5 cases) and aortoiliac and renal tromboendarterectomy (2 cases). Morbidity included: renal failure (14 cases), mesenteric ischemia (4 cases), cardiac complications (7 cases), respiratory complications (5 cases) and loss of extremity (2 cases). The in-hospital mortality was 21% (EM 0%, TR 21%). The estimated survival at 1.3 and 5 years was 60, 50 and 44% respectively. Age (p = 0.032), arterial hypertension (p = 0.039) and aetiology of the AAO (p = 0.039) were related to mortality. CONCLUSIONS: Acute aortic occlusion is a medical emergency with high mortality rates. Acute renal failure is the most common postoperative complication

Outcomes after treatment of acute aortic occlusion.

INTRODUCTION: Acute aortic occlusion (AAO) is a rare disease with high morbidity and mortality. The aim of this study was to describe the results of surgical treatment of acute aortic occlusion and risk factors for mortality. METHODS: Retrospective review of the clinical history of 29 patients diagnosed and operated on for AAO during 28 years. The following variables were analysed: age, sex, tabaco use, diabetes, chronic renal insufficiency, chronic heart failure, atrial fibrillation, arterial hypertension, symptoms, diagnosis and treatment, 30-day mortality and long-term survival. A univariant analysis was performed of variables related to mortality. RESULTS: Twenty-nine patients were included (18 male) with a mean age of 66,2 years. The aetiology was: embolism (EM) in 11 cases and Thrombosis (TR) in 18 cases. The surgical procedures performed included bilateral transfemoral thrombectomy (14 cases), aorto-bifemoral by-pass (8 cases), axilo uni/bifemoral by-pass (5 cases) and aortoiliac and renal tromboendarterectomy (2 cases). Morbidity included: renal failure (14 cases), mesenteric ischemia (4 cases), cardiac complications (7 cases), respiratory complications (5 cases) and loss of extremity (2 cases). The in-hospital mortality was 21% (EM 0%, TR 21%). The estimated survival at 1.3 and 5 years was 60, 50 and 44% respectively. Age (p=0.032), arterial hypertension (p=0.039) and aetiology of the AAO (p=0.039) were related to mortality. CONCLUSIONS: Acute aortic occlusion is a medical emergency with high mortality rates. Acute renal failure is the most common postoperative complication.