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[Long-term results after surgery for aortic arch nondissection aneurysm]
M Nakai1, M Shimamoto, F Yamazaki
1Department of Cardiovascular Surgery, Shizuoka City Hospital, Shizuoka, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 24, 2002
Summary
Surgical repair of aortic arch aneurysms using hypothermic extracorporeal circulation with cerebral perfusion showed significant differences in outcomes between elective and emergent cases. Emergent operations had higher mortality and neurological dysfunction rates compared to elective procedures.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Context:
- Aortic arch aneurysms pose significant surgical challenges.
- Nondissection fusiform or saccular types require specialized repair techniques.
- Hypothermic extracorporeal circulation with cerebral perfusion is a key surgical strategy.
Purpose:
- To evaluate the outcomes of surgical treatment for aortic arch aneurysms.
- To compare results between elective and emergent surgical interventions.
- To assess early and long-term survival and neurological complications.
Summary:
- 109 patients underwent surgical repair for aortic arch aneurysms between 1990 and 2001.
- Procedures included hemiarch, total arch, and distal arch replacement using hypothermic extracorporeal circulation with cerebral perfusion.
- Emergent operations (15 patients) had significantly higher early mortality (53.3%) and permanent neurological dysfunction (46.7%) than elective operations (8.5% and 12.8%, respectively).
Impact:
- The study highlights the critical impact of surgical timing on patient outcomes for aortic arch aneurysms.
- Long-term survival rates at 5 and 10 years were 52% and 29%, respectively.
- A 5-year event-free survival rate of 89% was observed, underscoring the potential for successful long-term management in elective cases.