The ARCH Projects: design and rationale (IAASSG 001)

Area of Science:

• Cardiovascular Surgery
• Neurosurgery
• Surgical Outcomes Research

Background:

• Current aortic arch studies face limitations including small patient numbers, varied definitions, diverse techniques, and poor outcome reporting.
• A lack of collaborative effort hinders robust investigation into neuroprotection strategies during aortic arch surgery.

Purpose of the Study:

• To establish an international coalition of high-volume aortic arch centers to conduct more effective research.
• To improve the assessment of neuroprotection strategies and surgical outcomes in aortic arch surgery.
• To address limitations in current research methodologies and foster collaborative efforts.

Main Methods:

• Identification and recruitment of high-volume aortic arch centers globally.
• Convening a Research Steering Committee comprising expert arch surgeons.
• Initiating multiple research projects, including retrospective and prospective databases and randomized controlled trials.

Main Results:

• Formation of the International Aortic Arch Surgery Study Group with 41 surgeons from 10 countries.
• Establishment of a multi-institutional retrospective database.
• Initiation of randomized controlled trials and a prospective database.

Conclusions:

• This collaborative effort represents a significant advancement in managing aortic arch pathologies.
• Enhanced statistical power will enable better assessment of surgical techniques' impact on mortality and morbidity.
• The group will identify risk predictors, develop validated risk models, and evaluate long-term survival and quality of life.