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Published on: December 11, 2017
Branch-first Continuous Perfusion Aortic Arch Replacement: Midterm Results
Varun J Sharma1, Abbie R Kanagarajah2, Siven Seevanayagam1
1Department of Thoracic Aortic Surgery, Austin Health, Melbourne, Australia; Department of Cardiac Surgery, Austin Health, Melbourne, Australia; Department of Surgery (Austin Health), Melbourne Medical School, The University of Melbourne, Australia.
The branch-first continuous perfusion aortic arch replacement (BF-CPAR) technique offers excellent 10-year outcomes for both elective and emergency aortic arch surgeries, reducing mortality and morbidity associated with traditional methods.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Aortic arch surgery traditionally involves perfusion interruption, leading to increased risks.
- The branch-first continuous perfusion aortic arch replacement (BF-CPAR) technique aims to mitigate these risks.
Purpose of the Study:
- To describe the BF-CPAR technique.
- To report midterm outcomes of BF-CPAR over a 15-year period.
Main Methods:
- Analysis of 155 patients undergoing BF-CPAR from July 2005 to February 2021.
- Evaluation of demographic, procedural, and outcome data (mortality, reintervention, morbidity, stroke).
- Application of Kaplan-Meier and Cox regression for survival and event analysis.
Main Results:
- 10-year freedom from aortic death was 95.6% (elective) and 93.3% (emergency).
- 10-year freedom from any aortic reintervention was 72.8% (elective) and 29.2% (emergency).
- 10-year freedom from cerebrovascular events was 82.6% (elective) and 75.4% (emergency).
Conclusions:
- BF-CPAR demonstrates excellent 10-year results for both elective and emergency aortic arch replacement.
- The technique effectively overcomes the limitations of traditional aortic arch surgery.
