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Published on: December 11, 2017
Long-term results after proximal thoracic aortic redo surgery
Martin Czerny1, Ilan Barchichat, Katharina Meszaros
1Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland. martin.czerny@insel.ch
Plos One
|March 8, 2013
Summary
Redo surgery for proximal thoracic aortic conditions offers good early and mid-term outcomes. A critical preoperative state and high EuroSCORE risk scores predict mortality, not age alone, supporting surgical consideration.
Area of Science:
- Cardiovascular Surgery
- Thoracic Aortic Surgery
- Aortic Aneurysm Repair
Background:
- Redo surgery for proximal thoracic aortic disease presents unique challenges.
- Evaluating outcomes in this complex patient population is crucial for surgical decision-making.
Purpose of the Study:
- To assess the early and mid-term results of proximal thoracic aortic redo surgery.
- To identify predictors of adverse outcomes in patients undergoing repeat aortic procedures.
Main Methods:
- Analysis of 60 patients undergoing proximal thoracic aortic redo surgery (2005-2012).
- Evaluation of in-hospital mortality, perioperative complications, and long-term survival.
- Risk factor analysis using EuroSCORE I, EuroSCORE II, and logistic regression.
Main Results:
- In-hospital mortality was 13%, with 7% experiencing neurologic injury.
- Urgent/emergency settings accounted for 50% of cases; 65% involved arch replacement.
- EuroSCORE I and II reliably predicted outcomes; critical preoperative state was the strongest mortality predictor, not age.
Conclusions:
- Proximal thoracic aortic redo surgery yields excellent early and mid-term results despite significant early risks in critically ill patients.
- High EuroSCORE values and critical preoperative status are independent predictors of mortality.
- Age should not be a contraindication for surgical intervention in this patient group.
