Aortic arch operation using selective cerebral perfusion for nondissecting thoracic aneurysm

Area of Science:

• Cardiovascular Surgery
• Thoracic Aneurysm Repair
• Cerebral Perfusion Techniques

Background:

• The risks associated with aortic arch operations using selective cerebral perfusion for nondissecting aneurysms remain unclear.
• A need exists to determine factors influencing mortality and disability in these complex procedures.

Purpose of the Study:

• To evaluate the predictors of mortality and disability in patients undergoing aortic arch surgery with selective cerebral perfusion.
• To identify patient characteristics and conditions that impact outcomes after thoracic aneurysm repair.

Main Methods:

• A multicenter, retrospective study involving 143 patients undergoing aortic arch or extensive aortic reconstruction.
• Procedures included graft replacement, extensive aortic reconstruction, and patch repair.
• A mean follow-up of 19 months was conducted.

Main Results:

• Hospital mortality was 25.2% (36/143 patients).
• Independent predictors for vascular death included aneurysmal rupture and renal dysfunction.
• Neurologic deficits occurred in 10.5% of patients, with reoperation needed for 13 patients.

Conclusions:

• Age, aneurysmal rupture, and renal dysfunction are significant predictors of mortality and disability.
• These findings are crucial for risk stratification in aortic arch operations.
• Selective cerebral perfusion for nondissecting thoracic aneurysms requires careful patient selection and management.