Browsing by Author "Valdebenito, Magaly"

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    Endovascular repair of abdominal aortic aneurysm.: Results in 80 consecutive patients
    (2006) Valdes, Francisco; Mertens, Renato; Kramer, Albrecht; Bergoeing, Michel; Marine, Leopoldo; Canessa, Roberto; Huete, Alvaro; Vergara, Jeanette; Valdebenito, Magaly; Rivera, Dixiana
    Background: Endovascular repair of abdominal aortic aneurysms (AAA) avoids laparotomy, shortens hospital stay and reduces morbidity and mortality related to surgical repair allowing full patient recovery in less time. Aim: To report short and long term results of endovascular repair of AAA in 80 consecutive patients treated at our institution. Patients and Methods: Between September 1997 and February 2005, three women and 77 men with a mean age 73.6 +/- 7.7 years with AAA 5.8 +/- 1.0 cm in diameter, were treated. The surgical risk of 38% of patients was grade III according to the American Society Anesthesiologists classification. Each procedure was performed in the operating room, under local or regional anesthesia, with the aid of digital substraction angiography. The endograft was deployed through the femoral artery (83,7016 bifurcated 16.3% tubular graft). A femoro-femoral bypass was required in 11.3% of cases. Follow-tip included a spiral CT scan at 1, 6 and 12 months postoperatively, and then annually). Results. Endovascular repair was successfully completed in 79/80 patients (98.7% technical success). The procedures lasted 147 +/- 71 min. Length of stay in the observation unit was 20.6 +/- 73.5 h. Blood transfusion was required in 10%. Sixty two percent of the patients were discharged before 72 h. One patient died 8 days after surgery due to a myocardial infarction (1.3%. During follow-up (3-90 months), 1 patient developed late AAA enlargement due to a type I endoleak, requiring a new endograft. No AAA rupture was observed. Survival at 4 years was 84.2% (SE = 9.2). Endovascular re-intervention free survival was 82.7% (SE = 9.5). Conclusion: Endovascular surgery allows affective exclusion of AAA avoiding progressive enlargement and/or rupture and is a good alternative to open repair Close and frequent postoperative follow up is mandatory.
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    Extra anatomical revascularization and endovascular stent-grafting for thoracoabdominal aneurysm repair. Report of four cases
    (2007) Mertens, Renato; Valdes, Francisco; Kramer, Albrecht; Marine, Leopoldo; Bergoeing, Michel; Sagues, Rodrigo; Huete, Alvaro; Vergara, Jeannette; Valdebenito, Magaly
    Surgical treatment of thoracoabdominal aneurysms is a big technical challenge with a high rate of complications and mortality. It requires a large exposure and transient interruption of vital organ perfusion during its repair. Endovascular repair is a less invasive alternative available over the last decade. We report four male patients aged 44 to 76 years, with thoracic aortic aneurysms and involvement of visceral aorta, treated with a two stage procedure. During the first stage, a retrograde revascularization of the superior mesenteric and renal arteries from the infrarenal aorta was done, associated in two cases to a concomitant repair of an infrarenal aortic aneurysm. In the second stage, an endovascular graft was placed through the femoral artery, from the segment proximal to the aneurysm to the infrarenal aorta, above the origin of the visceral artery reconstructions, excluding the aneurysm from circulation. In one patient, both stages were concomitant and in three the second stage was delayed. One patient presented a postoperative bleeding that required reintervention without adverse consequences. No patient died, presented paraplegia or deterioration of renal function. After follow up of 6 to 20 months, there is no evidence of aneurysm growth or complications derived from the procedure.