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Long-term outcomes in thoracic aortic surgery: 11 year single centre experience
Edward Staniforth1, Iakovos Ttofi2, Jasmina Ttofi2
1Oxford University Medical School, Medical Sciences Division, University of Oxford, Oxford, UK.
Journal of Cardiothoracic Surgery
|December 20, 2024
Summary
Thoracic aortic surgery patients face a high re-operation rate, especially within the first five years. Young age and aortitis are key risk factors, necessitating vigilant follow-up by specialized aortic services.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Thoracic aortic surgery is complex, with ongoing debate regarding risk factors for re-operation and optimal follow-up duration.
- Regular clinical and imaging follow-up is recommended for patients undergoing thoracic aortic surgery.
Purpose of the Study:
- To identify risk factors associated with re-operations in patients who underwent thoracic aortic surgery.
- To evaluate the significance of the early post-operative period for re-operation risk.
Main Methods:
- Retrospective review of 409 patients undergoing thoracic aortic surgery between 2012 and 2022.
- Analysis of clinical data, operative details, histology, outcomes, and follow-up records.
- Statistical analysis using logistic regression to identify risk factors.
Main Results:
- A 10.8% re-operation rate was observed, with a median time to re-operation of 1.8 years.
- 68% of re-operations occurred within the first 5 years post-surgery.
- Young age and aortitis were significant risk factors for re-operation; bicuspid aortic valve was associated with reduced risk.
Conclusions:
- Thoracic aortic surgery patients have a high re-operation rate, with the first 5 years being critical.
- Specialist follow-up with imaging is essential during this high-risk period.
- Patients with aortitis require specialized management due to persistently high re-operation risk.
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