Technical advances improved outcome in patients undergoing surgery of the ascending aorta and/or aortic arch: ten years experience

Krähenbühl, Eva S; Immer, Franz F; Stalder, Mario; Englberger, Lars; Eckstein, Friedrich S; Schmidli, Jürg; Carrel, Thierry P (2008). Technical advances improved outcome in patients undergoing surgery of the ascending aorta and/or aortic arch: ten years experience. European journal of cardio-thoracic surgery, 34(3), pp. 595-9. Oxford: Elsevier Science B.V. 10.1016/j.ejcts.2008.04.051

[img]
Preview
Text
34-3-595.pdf - Published Version
Available under License Publisher holds Copyright.

Download (275kB) | Preview

BACKGROUND: Several technical advances in thoracic aortic surgery, such as the use of antegrade cerebral perfusion, avoidance of cross-clamping and the application of glue, have beneficially influenced postoperative outcome. The aim of the present study was to analyse the impact of these developments on outcome of patients undergoing surgery of the thoracic aorta. METHODS AND RESULTS: Between January 1996 and December 2005, 835 patients (37.6%) out of 2215 aortic patients underwent surgery on the thoracic ascending aorta or the aortic arch at our institution. All in-hospital data were assessed. Two hundred and forty-one patients (28.8%) suffered from acute type A dissection (AADA). Overall aortic caseload increased from 41 patients in 1996 to 141 in 2005 (+339%). The increase was more pronounced for thoracic aortic aneurysms (TAA) (+367.9%), than for acute type A aortic dissections (+276.9%). Especially in TAA, combined procedures increased and the amount of patients with impaired left ventricular function (EF <50%) raised up from 14% in 1996 to 24% in 2005. Average age remained stable. Logistic regression curve revealed a significant decrease in mortality (AADA) and in the overall incidence of neurological deficits. CONCLUSIONS: Technical advances in the field of thoracic aortic surgery lead to a decrease of mortality and morbidity, especially in the incidence of adverse neurological events, in a large collective of patients. Long-term outcome and quality of life are better, since antegrade cerebral perfusion has been introduced.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Roost, Eva; Immer, Franz F.; Stalder, Mario; Englberger, Lars; Eckstein, Friedrich Stefan; Schmidli, Jürg and Carrel, Thierry

ISSN:

1010-7940

ISBN:

18579397

Publisher:

Elsevier Science B.V.

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:05

Last Modified:

27 Apr 2018 10:05

Publisher DOI:

10.1016/j.ejcts.2008.04.051

PubMed ID:

18579397

Web of Science ID:

000259911900024

BORIS DOI:

10.7892/boris.28286

URI:

https://boris.unibe.ch/id/eprint/28286 (FactScience: 119549)

Actions (login required)

Edit item Edit item
Provide Feedback