Reoperative repair of descending thoracic and thoracoabdominal aneurysms

OBJECTIVES: To evaluate the results of reoperation on descending thoracic and thoracoabdominal aneurysms. METHODS: Sixty-nine consecutive patients undergoing reoperative aneurysm repair (20 descending thoracic and 49 thoracoabdominal) were compared to 602 contemporary primary repairs. Propensity matching was used to reduce observable differences in preoperative characteristics. RESULTS: The reoperation group was younger (60.2 vs 65.3 years, P = 0.005) and less were extent I or II (28.6% vs 76%, P   0.05 for all variables), with the exception of myocardial infarction (2.9% vs 0.5%, P = 0.028). Five-year survival was 57.6% in reoperations and 58% in the primary surgery group (P = 0.878). No differences in the in-hospital and follow-up outcomes were found in the propensity matched comparison. CONCLUSIONS: Reoperative repair of descending thoracic and thoracoabdominal aneurysms can be safely performed with reasonable in-hospital and follow-up outcomes compared to primary aneurysm repair.