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Outcomes of aortic arch replacement surgery after previous cardiac surgery
- Source :
- ANZ Journal of Surgery. 83:827-832
- Publication Year :
- 2013
- Publisher :
- Wiley, 2013.
-
Abstract
- Background Aortic arch replacement is a potentially high-risk operation and in the re-operative setting has been found to be a risk factor for poor outcome, yet there is a dearth of published data specifically on this topic. The aim of the study was to review our unit's outcomes in this re-operative setting. Method Data were collated for all patients who underwent aortic arch replacement surgery after previous cardiac surgery from January 1988 to November 2011. The patients were divided based primarily on elective versus non-elective and also early (≤2005) and late (≥2006) series. Results Twenty-seven eligible patients (22 male; median age: 53.0 years; elective: 14, non-elective: 13) were identified. There was a mean period of 14.5 years between the first operation and the subsequent aortic arch replacement. The overall 30-day mortality rate was 22.2% – 0% elective and 46.2% non-elective (P = 0.004). Overall permanent neurological dysfunction was 21.7% – 28.6% elective and 11.1% non-elective (P = 0.463). There were 11 early-series patients and 16 late-series patients. For early-series patients, 90.9% were non-elective versus 18.8% in the late-series patients. The 30-day mortality rate was 54.5% early series versus 0% late series. Conclusion Aortic arch replacement is high risk in the re-operative setting. These risks are even greater for non-elective procedures. This highlights the need for aggressive first-time surgery to reduce re-operative procedures and good long-term follow-up programmes to allow elective procedures if required.
- Subjects :
- Aortic dissection
Aortic arch
medicine.medical_specialty
business.industry
Mortality rate
General Medicine
medicine.disease
Cardiac surgery
Surgery
health services administration
medicine.artery
medicine
Aortic arch replacement
Neurological dysfunction
Risk factor
business
health care economics and organizations
Subjects
Details
- ISSN :
- 14451433
- Volume :
- 83
- Database :
- OpenAIRE
- Journal :
- ANZ Journal of Surgery
- Accession number :
- edsair.doi...........a5c2be051408ad66631fa8902cb553f7
- Full Text :
- https://doi.org/10.1111/ans.12299