Surgical aspects of thoracic aortic aneurysms: A case series from a real-world setting

BACKGROUND: The objective of the present study is to review different surgical features and treatment modalities of thoracic aortic aneurysms. METHODS: This was a retrospective study of 17 patients operated on for thoracic aortic aneurysm in the Department of Cardiovascular Surgery of the Military Hospital of Rabat (Morocco) over a 10-year period, from January 2007 to December 2016. All patients with aneurysms located in the thoracic aorta or extended to the abdominal aorta were included in the study. RESULTS: The mean age of the patients was 49 ± 6 years. 58% of the patients were symptomatic. 10 patients (62%) had an aneurysm of the ascending thoracic aorta and 2 patients had an aneurysm of the ascending aorta extended to the arch. In 2 patients, the aneurysm was located in the descending thoracic aorta. Three patients (18%) had a post-traumatic false aneurysm of the aortic isthmus. Six patients underwent a Bentall procedure. One patient underwent the Yacoub technique. Two patients underwent ascending aorta replacement using the Wheat technique. In addition, two patients underwent ascending aorta and arch replacement and five patients (29%) underwent descending thoracic aorta replacement. In-hospital mortality was 12%. Two patients (12%) developed paraplegia and two developed renal failure (12%). CONCLUSION: Thoracic aortic aneurysms are a serious pathology requiring surgical treatment before complications arise. Replacement of the arch and the descending thoracic aorta still remain a challenge for cardiovascular surgeons because of neurological complications.