Intermediate outcomes following arch reconstruction with frozen elephant trunk, a single centre study

Journal of Cardiothoracic Surgery

Research

Therese Schagerholm Dahl¹  Rickard P. F. Lindblom² 

[1]Department of Surgical Sciences, Section of Thoracic Surgery, Uppsala University, Uppsala, Sweden

[2]Department of Surgical Sciences, Section of Thoracic Surgery, Uppsala University, Uppsala, Sweden

[3]Department of Cardiothoracic Surgery and Anesthesia, Uppsala University Hospital, 751 85, Uppsala, Sweden

关键词: Frozen elephant trunk;    Neurological outcomes;    Aortic arch;   

DOI  :  10.1186/s13019-023-02140-5

 received in 2022-02-15, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSurgery on the aortic arch and proximal descending thoracic aorta can be lifesaving but is also associated with significant morbidity, ranging from minor infections to severe neurological impairments as well as a substantial risk of mortality. The aim of this study is to clinically assess outcomes, with special regards to neurologic injury, as well as to seek to identify predictors of in-hospital mortality in two patient groups with different underlying aortic pathology, aneurysms and dissections, undergoing arch/descending aortic repair.Methods34 patients (17 aneurysms, 17 dissections) underwent surgery involving the arch and/or descending aorta, using the Thoraflex or E-Vita frozen elephant trunk graft. 40% were female. Subgroup analysis of aneurysms compared to dissections were performed. Mean follow-up time was 53.9 months and mean age 63.5 years.ResultsIn-hospital mortality was 18%. Survival was comparable between aneurysms and dissections. Incidence of spinal cord injury was 9% and stroke 9%. 67% suffered any form of neurological affection, when also cognitive afflictions were included. Perioperative reoperation rate was 29% (bleeding 21%, visceral ischemia 6%, infection 2%), the need for postoperative dialysis was 11% and a series of other minor complications such as atrial fibrillation and pleurocentesis were common.ConclusionPostoperative dialysis was found to be a predictor of in-hospital mortality, while both dialysis as well as reoperation due to bleeding and/or visceral ischemia increased the risk for overall mortality, irrespective of preoperative diagnosis. Previous or current smoking appeared to be associated with negative outcomes regarding both in-hospital and overall mortality during follow-up.Trial registration Retrospectively enrolled.

【 授权许可】

CC BY   
© The Author(s) 2023

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