Kardiologie up2date 2009; 5(1): 65-75
DOI: 10.1055/s-0028-1119663
Aortenerkrankungen

© Georg Thieme Verlag KG Stuttgart · New York

Risiken der Aortenchirurgie

Bartosz  Rylski, Friedhelm  Beyersdorf
Further Information

Publication History

Publication Date:
26 March 2009 (online)

Abstract

In the last few decades the surgical therapy of aortic diseases has enormous improved. However, aortic surgery still carries a high risk of complications. Nearly 80 % of patients with aortic diseases are older than 65 years. Every year the number of operated old and multimorbid patients increases. Nowadays there are two surgical methods available: the endovascular and open repair of aortic diseases. Besides the usual hazards of any anesthesia and operation, there are several particular postoperative problems which may arise following aortic grafting for aneurysm, dissection or occlusive disease. The most common complications may be classified as those that occur after open and endovascular repair, including bleeding, intestinal, kidney and spinal ischemia, graft infection, aortoenteric fistula and impotence and those that appear only after endovascular stent graft repair, including endoleaks, postimplantation syndrome, stent thrombosis, complications due to contrast media and exposure to radiation and cholesterol crystal embolism. The endovascular and open repair have different advantages and the indication for one of them depends of individual patient‘s risk-benefit analysis. That is why both surgical methods should be considerd as complementary procedures in the aortic surgery.

Kernaussagen

Etwa 80 % der Patienten mit Aortenerkrankungen sind über 65 Jahre alt. Tendenziell werden jedes Jahr mehr multimorbide und ältere Patienten operiert.

Die häufigsten Komplikationen nach Aortenchirurgie sind:

  • Blutungen

  • Ischämien (Darm-, Nieren-, Hirn- und Rückenmarkischämie)

  • Infektionen

  • Nahtaneurysmen

  • Anastomosenstenosen

  • Bauchwandhernien

  • aortoenterale Fisteln

  • Potenzstörungen

Nach interventioneller Stentgraft-Behandlung können folgende Komplikationen auftreten:

  • Endoleaks

  • Postimplantationssyndrome

  • Thrombosen der Prothese

  • Cholesterin-Embolie-Syndrom

Offene Chirurgie und endovaskuläre Interventionen sollen nicht konkurrierend, sondern komplementär verstanden werden.

Literatur

Dr. med. Bartosz Rylski

Chirurgische Universitätsklinik
Herz- und Gefäßchirurgie
Universitätsklinik Freiburg

Hugstetter Str. 55
79106 Freiburg

Email: rylski@gmx.de