Risiken der Aortenchirurgie

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.