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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The risks associated with elective repair of an abdominal aortic aneurysm have been reduced in recent years, but occasionally the extent of the aneurysm and the severity of the atherosclerotic process lead to life-threatening complications. The complications of myocardial infarction, acute renal failure, bleeding, and ischemia are examined in this article. To illustrate the complexities of nursing care when patients experience complications, the case of Mr. S is presented. Assessment and monitoring are considered as key components of nursing care, and ways to help patients and their families cope with unanticipated complications are outlined.
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PMID:Caring for patients with complications after elective abdominal aortic aneurysm surgery: a case study. 784 66

Acute lung injury as a remote sequela of severe lower torso ischemia-reperfusion has been demonstrated experimentally, in a process involving leukosequestration and generation of the arachidonate derivatives thromboxane and leukotriene B4. However, contemporary clinical reports have been limited to development of transient, subclinical "reperfusion pulmonary edema" several hours after declamping in patients undergoing elective abdominal aortic aneurysm repair. This report refocuses attention on the clinical syndrome of severe, acute deterioration in pulmonary function occurring several hours after restoration of perfusion to an ischemic lower torso in two patients. The lung injury is characterized by progressive hypoxemia, pulmonary hypertension, decreased lung compliance, and non-hydrostatic pulmonary edema, consistent with adult respiratory distress syndrome (ARDS). This report reinforces the concept that humoral mediators generated at reflow may induce end-organ injury at a site remote from the focus of ischemia-reperfusion, and that the lung is a target organ.
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PMID:Pulmonary failure following lower torso ischemia: clinical evidence for a remote effect of reperfusion injury. 789 94

Since the incidence of inflammatory arterial disease has been higher in Japan, its surgical treatment has been one of the main themes of vascular surgery from its beginning in this country. Buerger disease has been the main cause of chronic occlusive arterial disease before the middle of 1970s. and many patients suffered from intractable ischemic leg ulcer with severe pain. Reconstructive surgery, however, has been so much limited that number of the candidates for bypass surgery were around 10% of the patients, because of distal nature of the disease. We have developed a new technique in distal bypass surgery named as Esmarch's rubber bandage method, which was intended to minimize surgical injury to the host artery, and the results of its application to Buerger disease is very encouraging, and we have confirmed that this technique enables a bypass to the collateral arteries and muscular branches in place of the diseased tibio-peroneal artery. We expect this technique will clear a new avenue to surgical treatment of Buerger disease with limb threatening ischemia. In Takayasu's arteritis, the carotid reconstruction was popular between the late 1950s and 1960s and, at the same time atypical coarctation, renovascular hypertension, and aneurysm, along with their combined lesion became the objects of vascular surgery. This expansion of surgical indication contributed to the improvement of the prognosis and rehabilitation of the patients. Long term function of the reconstruction has been also confirmed. On the other hand, several problems emerged with the widespread application of vascular reconstruction which were peculiar to the disease state. Among them, the most important problems were neurological complications due to sudden increase in the intracranial blood pressure after carotid reconstruction, and anastomotic aneurysm as the delayed complication affecting eventual outcome which are inherent to the inflammation and extensive destruction of the medial component in this disease. A new method to prevent the postoperative neurological complications is discussed in this report. To improve the long term survival, meticulous observation of postoperative course is essential in Takayasu's arteritis. Recently, abdominal aortic aneurysms showing the peculiar gross appearance and clinical presentation have become the subject of discussion as inflammatory abdominal aortic aneurysm because of remarkable thickening of the aneurysmal wall and a severe inflammatory change, and some difficulties of its surgical treatment have been stressed in the most of the reports. The recent researches offered the conclusion that etiology of the aneurysm is not inflammation, but inflammatory reaction during formation of atherosclerotic aneurysm.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Surgical treatment of intractable vasculitis syndromes--with special reference to Buerger disease, Takayasu arteritis, and so-called inflammatory abdominal aortic aneurysm]. 793 11

This article reviews the most immediate postoperative complications after abdominal aortic aneurysm surgery. Acute limb ischemia, thromboembolism and pulmonary embolism, postoperative bleeding, and compartment syndrome are described with the associated nursing implications. Prosthetic graft problems are discussed and suggestions for prevention are offered.
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PMID:Abdominal aortic aneurysm surgery, Part II: Major complications and nursing implications. 796 Aug 61

The authors report their experience relative to 8 patients who underwent IMA revascularization during infrarenal AAA repair. The Carrel patch technique was employed in all cases operated. With this procedure no ischemic intestinal complication occurred. Two cases of ischemic colitis were observed in a second group of 40 patients operated for AAA in whom the IMA wasn't reimplanted into the aortic graft. The overall incidence of acute intestinal ischemia was 4%.
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PMID:[Indications for reimplantation of the inferior mesenteric artery in the course of prosthetic substitution for the subrenal aorta]. 809 Feb 96

At a time of potentially dramatic changes in health care policy in this country, and in view of the necessity for health care cost containment, physicians are expected to exercise serious introspection in the selection of treatment for the elderly patient with peripheral arterial disease. These decisions should be made while acknowledging that it is the goal of the health-care provider "to postpone chronic illness, to maintain vigor, and to slow social and psychological involution." For the elderly patient with an abdominal aortic aneurysm, with significant carotid disease, or with limb-threatening peripheral ischemia, the evidence is compelling that timely surgical intervention in properly selected patients is well tolerated and will satisfy this goal.
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PMID:Vascular disease in the elderly patient. 810 68

Abdominal aortic aneurysm resections were performed on 941 patients between 1987 and 1991 in nine selected university vascular units in Poland. The aim of the study was (1) to determine how grave the problem of abdominal aortic aneurysms is in the main vascular centres in our country, (2) to evaluate the methods of management, (3) to trace the most common postoperative complications, and (4) to estimate results. Hospital mortality rate for 730 elective and urgent resections was 8.2%. The emergency resection mortality rate for ruptured aneurysm was 60.2%. The most common postoperative general complications were: cardiac (178-18.9%), pulmonary (76-8.1%), renal failure (58-6.2%) and cerebrovascular accidents (23-2.4%). The postoperative local complications (113) occurred in 87 (9.2%) patients. The most common were: colon ischemia (22-3.5%), haemorrhage (30-3.2%), acute graft occlusion (22-2.3) and peripheral embolism (19-2%). Sixty-five patients required early reoperation undergoing a total of 74 additional operative procedures. The local complications occurring in analysed material significantly influenced the results. Mortality in reoperated patients was almost twice as high as among those not reoperated (p < 0.01). Analysis of the material revealed no differences in the obtained results of aneurysm surgery in the succeeding years of our study, when expecting improvement in the last years. The cause of this could be treatment of more high risk patients. The absolute number of patients with abdominal aortic aneurysms referred to the unit influenced results.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical management of abdominal aortic aneurysms in Poland. A multi-centre study. 820 5

Peripheral tissue oxygenation was monitored with near infrared spectrophotometry during abdominal or common iliac aortic cross-clamping surgery. Six patients who had abdominal aortic aneurysm (AAA) and eight patients who had aortic sclerotic occlusive disease (ASO) were studied. At the beginning of cross-clamping, oxyhemoglobin was decreasing and deoxyhemoglobin was increasing in all AAA patients. Average of 37 minutes following cross-clamping of abdominal aorta, both hemoglobin values were stabilized. On the other hand, changes in both hemoglobin values were delayed or missing in ASO patients. The results suggest that the duration from cross-clamping to stabilization is related to co-lateral blood flow. During operation, monitoring of peripheral blood flow with near infrared spectrophotometry is useful for detection of peripheral ischemia and for the estimation of postoperative local blood flow.
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PMID:[Monitoring of peripheral tissue oxygenation with near infrared spectrophotometry during abdominal or iliac aortic cross-clamping surgery]. 836 64

Infrarenal aortic cross-clamping required during surgical treatment of abdominal aortic aneurysm is generally well tolerated but can be occasionally associated with severe cardiac and haemodynamic disturbances, particularly in patients suffering from coronary artery disease. We compared the haemodynamic changes and the ECG-records before and shortly after infrarenal aortic clamping in three groups of 20 patients (group I: without coronary artery disease, group II: with overt coronary disease without indication for prior myocardial revascularization, and group III: patients undergoing combined procedure: coronary artery bypass immediately prior to aortic repair, during the same anesthesia). There was no significant difference in demographical characteristics between the three groups. Aortic cross-clamping lead to an increase in systemic arterial pressure in all patients. Group I demonstrated a decrease in pulmonary artery pressure, pulmonary capillary wedge pressure and central venous pressure, whereas patients of group II demonstrated an increase of each value when the aorta was clamped. 11 patients of this group developed either arrhythmia and/or ischemia during aortic cross-clamping. Haemodynamic and cardiac effects of aortic clamping seen in patients who had received coronary bypass immediately prior to aortic repair (group III) were surprisingly similar to those of patients without coronary disease, probably owing to systematic application of 2 vasodilators. Tolerance to infrarenal aortic cross-clamping differs in patients with and without coronary artery disease. Development of myocardial ischemia may be predicted by an increase in wedge pressure after clamping. Afterload reduction was the best treatment of ischemia occurring when the aorta was clamped.
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PMID:[Effect of aortic clamping on heart function in elective operation of the abdominal aorta: immediate effects of coronary revascularization]. 837 52

To clarify the influence of clamping of aorta on ischemic heart, 235 patients who underwent abdominal aortic surgery from 1980 to 1989 were studied. One hundred and twenty patients underwent resection of abdominal aortic aneurysm, and 115 patients underwent operation for aortoiliac occlusive disease. Myocardial infarction occurred in 8 patients, and 4 patients died. The onsets of the myocardial infarction were later than the 3rd post operative day in every patient but one. There were no significant differences in the incidence of myocardial infarction between the patients of nonruptured abdominal aortic aneurysm and of aortoiliac occlusive disease. To clarify the hemodynamic changes during abdominal aortic procedure, following experiments were performed using dogs. The dogs were divided into 6 groups, Groups 1, 3, 5; normal control groups, Group 2, 4, 6; groups with coronary stenoses. The infrarenal aorta were cross-clamped in groups 1, 2, 3, 4. In groups 3 and 4, PGE1 were administrated continuously into the infrarenal aorta below the clamping sites. In groups 5 and 6, descending thoracic aorta were cross-clamped. In group 6, one dog developed ventricular fibrillation at 60 minutes after aortic cross-clamping. Moreover ECG of the other dog of group 6 demonstrated myocardial ischemia during aortic clamping. But there were no significant differences in hemodynamic variables between groups, 1, 3, 5 and 2, 4, 6. These results indicate that aortic clamping can induce the myocardial ischemia, but that ischemia is not the chief cause of postoperative myocardial infarction.
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PMID:[Clinical and experimental study of hemodynamic changes during aortic surgery]. 837 62


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