Hospital and Long-term Outcomes of Aortic Arch Surgery

pp. 435-439

Abstract

Introduction: Treatment of patients with acute or chronic aortic arch disease has been historically associated with poor outcomes.

Objectives: Aim of this study was to analyze in-hospital and long-term outcomes of aortic arch replacement comparing emergency and elective procedures.

Methods: We conducted a retrospective cohort study in patients undergoing aortic arch surgery in a high complexity center with 1-year follow-up between January 2010 and December 2016.

Results: A total of 65 patients were included; 65% were men and median age was 71 years. Among postoperative complications, requirement of prolonged mechanical ventilation was more common in the emergency surgery group compared with the elective surgery group (52% vs. 19%, p = 0.006). The incidence of reoperation due to bleeding, mediastinitis, stroke, confusion and renal failure requiring dialysis in the postoperative period was similar in both groups. In-hospital mortality was 15% and observed mortality was 24%, without significant differences according to surgical timing.

Conclusions: In this cohort of patients undergoing aortic arch surgery, hospital mortality and 1-year mortality was similar in patients operated on in emergency or electively. Of importance, the risk of mortality was 4 times greater in patients > 75 years. The incidence of mortality and postoperative stroke was similar to that reported by recent registries. The incidence of reoperations due to bleeding was conspicuously low. The rate of complications (reoperations due to bleeding, stroke, acute renal failure or infection) was similar in both groups probably because of the lack of power of the sample.