Dengan segala kemajuan modern dalam pengobatan Aneurisma Aorta, mengapa perlu dilakukan operasi aneurisma terbuka?
Pertama, aneurisma aorta diindikasikan untuk pengobatan bila ukurannya di atas 5,5 cm tanpa gejala. Namun, bila pasien mengalami nyeri perut dan punggung serta memiliki aneurisma yang lebih besar dari 5,5 cm, hal ini diindikasikan untuk segera dilakukan, sebaiknya di rumah sakit yang sama.
Second, over 99 % of the aneurysm can be treated by stenting but there are times that the aneurysm will require a customized (tailor-made) stent device and this will take up to 8 to 12 weeks to make. Hence, we cannot wait that long because the aneurysm would rupture.
Thirdly, when the anatomy is very complex, the risk of putting a stent inside a patient may not be lower than open surgery. Take an example a complex four-fenestrated stent (stent with 4 branches) used in the treatment of aortic aneurysm will have a 6 to 8 % 30-day mortality but open surgery will carry around a 5 % 30-day mortality risk.
Terakhir, terdapat data ilmiah yang sangat baik bahwa jika pasien masih muda dan dapat hidup lebih dari 5 tahun, operasi terbuka akan lebih baik jika intervensinya lebih sedikit dan National Institute of Clinical Excellence Guidelines di Inggris masih merekomendasikan operasi terbuka sebagai pengobatan lini pertama.
This gentleman had a successful open aortic aneurysm repair by Dr Tang and Dr Wong 6 months ago. He is now back playing golf. His midline abdominal wound has healed up nicely and he now won’t need any surveillance CT scans for his abdominal aortic repair compared to if he had an endovascular stent repair which would need lifelong surveillance.
