Is organ ischaemia a determinant of the outcome of operations for suprarenal aortic aneurysms?

Objective: To find out if morbidity and mortality after thoracoabdominal ap proaches for suprarenal aortic aneurysms are related to the duration of org an ischaemia. Design: Retrospective study. Setting: University hospital, The Netherlands. Subjects: 72 operations for suprarenal aortic aneurysms. Main outcome measures: Duration of organ ischaemia, morbidity and mortality . Results: There were 72 patients with 3 group A (Crawford type III), 10 grou p B (Crawford type IV), 37 group C (supracoeliac), and 22 group D (supraren al) aneurysms. Median duration of ischaemia was 57 minutes for both the spi nal cord and the mesenteric arteries, and 59 and 63 minutes for the right a nd left renal arteries, respectively. There were 52 major complications in 33 patients. Mesenteric ischaemia of longer than 60 minutes was associated with a significant higher complication rate (21/32, 66% compared with 13/40 , 33%, p = 0.01). Spinal cord ischaemia of longer than 60 minutes was not a ssociated with a significantly increased incidence of paraplegia (2/40 comp ared with 6/32, p = 0.13). Conclusions: We conclude that with surgery for suprarenal aneurysms a signi ficant higher complication rate is noted with increased duration of mesente ric ischaemia.