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Intermediate outcomes following arch reconstruction with frozen elephant trunk, a single centre study
Therese Schagerholm Dahl1, Rickard P F Lindblom2,3
1Department of Surgical Sciences, Section of Thoracic Surgery, Uppsala University, Uppsala, Sweden.
Journal of Cardiothoracic Surgery
|January 22, 2023
Summary
Aortic arch and descending aorta repair is high-risk surgery. Postoperative dialysis and reoperations for bleeding/ischemia predict mortality, while smoking is linked to worse outcomes.
Area of Science:
- Cardiovascular Surgery
- Thoracic Aortic Surgery
- Aortic Pathology
Background:
- Aortic arch and proximal descending thoracic aorta surgery is lifesaving but carries significant risks.
- Complications include neurological impairment and mortality.
- This study assesses outcomes and identifies mortality predictors in aneurysm vs. dissection patients.
Purpose of the Study:
- To clinically assess outcomes of aortic arch/descending aorta repair.
- To specifically evaluate neurologic injury incidence.
- To identify predictors of in-hospital mortality in aneurysm and dissection patient groups.
Main Methods:
- 34 patients (17 aneurysms, 17 dissections) underwent repair using Thoraflex or E-Vita grafts.
- Subgroup analysis compared aneurysm and dissection outcomes.
- Mean follow-up was 53.9 months; mean age was 63.5 years.
Main Results:
- In-hospital mortality was 18%. Survival rates were similar for aneurysms and dissections.
- Neurological complications occurred in 67% (9% spinal cord injury, 9% stroke).
- Reoperation rates were 29% (bleeding, visceral ischemia), and 11% required postoperative dialysis.
Conclusions:
- Postoperative dialysis predicted in-hospital mortality.
- Dialysis and reoperation for bleeding/ischemia increased overall mortality risk, regardless of diagnosis.
- Smoking was associated with worse in-hospital and overall mortality outcomes.
