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Mid‐ L ong‐ T erm Results After Aortic Arch Repair Using a Four‐ B ranched Graft With Antegrade Selective Cerebral Perfusion
Author(s) -
Numata Satoshi,
Tsutsumi Yasushi,
Monta Osamu,
Yamazaki Sachiko,
Seo Hiroyuki,
Yoshida Shohei,
Samura Takaaki,
Ohashi Hirokazu
Publication year - 2013
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12166
Subject(s) - medicine , aortic dissection , aortic arch , cerebral perfusion pressure , surgery , aneurysm , stroke (engine) , elephant trunks , perfusion , survival rate , dissection (medical) , cardiology , aorta , mechanical engineering , engineering
Background and Aim of the Study The purpose of this study is to evaluate mid‐long‐term results of aortic arch replacement. Methods Between 1992 and 2012, 263 consecutive patients underwent aortic arch repair in our institution. Follow‐up rate was 92%, and 243 patients were enrolled in this study. Two hundred twelve patients (87%) underwent total arch replacement using a four‐branched graft with antegrade selective cerebral perfusion. Ninety‐nine patients (41%) were operated on for acute aortic dissection. Results Hospital mortality was 13.2%. The mean follow‐up duration was 3.6 ± 3.7 (0–19) years. Late mortality occurred in 38 patients, 4.3 ± 3.2 (0.3–14.1) years after surgery. The survival rates were 85%, 70%, and 50% at one, five, and 10 years. In the acute type A aortic dissection group, survival rate at one and five years was 86% and 79%. In the nonacute type A dissection group, one‐ and five‐year survivals were 85% and 62% (log‐rank test: p = 0.0027). The causes of late mortality were respiratory failure in five, aortic aneurysm rupture in six, cancer in four, stroke in eight, others in seven, and unknown in eight. Twenty‐six patients had another aortic intervention 3.6 ± 6.0 (0.04–19.6) years after arch repair. Seven patients had stroke after discharge 6.5 ± 3.9 (1.9–13.0) years after repair. Conclusions Mid‐long‐term results after aortic arch repair with antegrade selective cerebral perfusion were satisfactory. Acute type A aortic dissection did not negatively influence the mid‐long‐term survival. doi: 10.1111/jocs.12166 (J Card Surg 2013;28:537–542)