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Early and mid-term outcomes of the aortic arch surgery: experience from the low-volume centre

R. Brat, J. Gaj, J. Barta,

. 2015 ; 10 (-) : 31. [pub] 20150310

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc16000166

AIM: The aim of this retrospective study was to examine the early and mid-term outcomes for patients undergoing elective aortic arch surgery over a 13-years period in the single low-volume centre. Results of aortic arch surgery published in the literature are usually results of high-volume centers, but the majority of institutions have much lower caseload. METHODS: From January 1999 to March 2013 total of 353 surgeries on thoracic aorta were performed in our institution. Only 30 procedures (8.5%) were elective aortic arch surgeries. This group of patients was analyzed. RESULTS: Deep hypothermia alone and hypothermia with ortograde cerebral perfusion was used in 7 (23%) and 23 (77%) patients respectively. Mean core temperature was 22°C (17 - 26°C). Cannulation sites was axillary artery or brachiocephalic trunk in 17 (57%), femoral artery in 8 (27%) and ascending aorta or aortic arch in 5 (16%). Mean hypothermic circulatory arrest time was 39 min (15 - 74 min). There was one death due to multiorgan failure; all-cause mortality at 30 days was 3.3%. The frequency of other complications was permanent neurological deficit in 2 (6.7%), temporary neurological deficit in 2 (6.7%) and renal failure requiring hemodialysis in 2 (6.7%) patients. In the follow-up 13 patients died, remaining 16 are still alive. CONCLUSION: Despite the lower caseload and technical problems manifested by a higher number of re-operations for bleeding, the all-cause mortality at 30 days as well as mid-term results are comparable with results reported by the high-volume centres.

Citace poskytuje Crossref.org

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$a Brat, Radim $u Department of Cardiac Surgery, University Hospital in Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic. radim.brat@fno.cz. Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. radim.brat@fno.cz.
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$a AIM: The aim of this retrospective study was to examine the early and mid-term outcomes for patients undergoing elective aortic arch surgery over a 13-years period in the single low-volume centre. Results of aortic arch surgery published in the literature are usually results of high-volume centers, but the majority of institutions have much lower caseload. METHODS: From January 1999 to March 2013 total of 353 surgeries on thoracic aorta were performed in our institution. Only 30 procedures (8.5%) were elective aortic arch surgeries. This group of patients was analyzed. RESULTS: Deep hypothermia alone and hypothermia with ortograde cerebral perfusion was used in 7 (23%) and 23 (77%) patients respectively. Mean core temperature was 22°C (17 - 26°C). Cannulation sites was axillary artery or brachiocephalic trunk in 17 (57%), femoral artery in 8 (27%) and ascending aorta or aortic arch in 5 (16%). Mean hypothermic circulatory arrest time was 39 min (15 - 74 min). There was one death due to multiorgan failure; all-cause mortality at 30 days was 3.3%. The frequency of other complications was permanent neurological deficit in 2 (6.7%), temporary neurological deficit in 2 (6.7%) and renal failure requiring hemodialysis in 2 (6.7%) patients. In the follow-up 13 patients died, remaining 16 are still alive. CONCLUSION: Despite the lower caseload and technical problems manifested by a higher number of re-operations for bleeding, the all-cause mortality at 30 days as well as mid-term results are comparable with results reported by the high-volume centres.
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