[Long-term surgical outcomes of aortic arch aneurysm]

Between January 1990 and October 2001, arch replacement was performed in 99 patients with aortic arch aneurysm at Omiya Medical Center. For brain protection during surgery, antegrade selective cerebral perfusion was performed. There were 11 (11.1%) hospital death, and causes were heart failure (3), pneumonia (2), respiratory failure (1), mediastinitis (1), cerebral infarction (1), sepsis (1), myocardial infarction (1), and bleeding (1). During follow-up, 24 patients died, and causes were pneumonia (4), malignancy (3), heart failure (2), cerebral infarction (2), rupture of residual aneurysm (2), asthma (1), myocardial infarction (1), sepsis (1), multiple organ failure (1), traffic accident (1), and unknown (6). Postoperative survival was 75.2% at 3 years, 61.5% at 5 years, and 35.3% at 8 years. Event free ratio was 71.8% at 3 years, 58.6% at 5 years, and 30.8% at 8 years. Surgery of the aortic arch using selective cerebral perfusion is a safe and demonstrated acceptable short- and long-term outcomes.