OBJECTIVE

To analyze perioperative parameters and early postoperative results after implantation of renal and visceral arteries in patients undergoing thoracoabdominal aorta repair.

MATERIAL AND METHODS

TAA replacement with visceral artery implantation was performed in 96 patients between 2017 and 2021. Patients were divided into 3 groups depending on the method of implantation: group I — «Crawford» technique (n=29, 30.2%), group II — «Coselli» technique (n=34, 35.4%), group III — separate implantation («button» technique) (n=33, 34.4%).

RESULTS

Patients with connective tissue dysplasia were more common in group III compared to other groups (p_3—1=0.014, p_3—2=0.014). Aortic dissection was more common in group III compared to group II (p=0.007). «Shaggy» aorta and visceral artery lesions (stenosis, occlusion) were more common in group II compared to groups I and III (p<0.05). Intraoperative parameters and early postoperative results were similar in all groups. Visceral artery thrombosis occurred in 4 (4.2%) cases. Only 2 (2.1%) patients had visceral malperfusion and acute renal failure in early postoperative period. These ones underwent emergency surgery. Visceral artery stenoses in early postoperative period were detected only in 9 (10.4%) patients without clinical manifestations. At baseline, visceral artery stenoses were present in 42 (43.8%) patients. In-hospital mortality was 4.2% (n=4). There was no mortality associated with renal and visceral arteries in early period.

CONCLUSION

The «button» and Coselli techniques can significantly prolong implantation and organ ischemia compared to Crawford technique with the same outcomes. These techniques are preferable for young patients with connective tissue dysplasia. Indeed, we do not include abnormal aortic wall and prevent recurrence of local aneurysmal dilatation.