Document Detail

Technical advances improved outcome in patients undergoing surgery of the ascending aorta and/or aortic arch: ten years experience.
MedLine Citation:
PMID:  18579397     Owner:  NLM     Status:  MEDLINE    
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.
Eva S Krähenbühl; Franz F Immer; Mario Stalder; Lars Englberger; Friedrich S Eckstein; Jürg Schmidli; Thierry P Carrel
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Publication Detail:
Type:  Journal Article     Date:  2008-06-25
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  34     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2009-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  595-9     Citation Subset:  IM    
Department of Cardiovascular Surgery, University Hospital, 3010 Berne, Switzerland.
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MeSH Terms
Acute Disease
Aneurysm, Dissecting / surgery*
Aorta / surgery
Aorta, Thoracic / surgery
Aortic Aneurysm / surgery*
Aortic Aneurysm, Thoracic / surgery
Blood Vessel Prosthesis Implantation / adverse effects,  methods*,  trends
Cerebrovascular Circulation
Cerebrovascular Disorders / etiology,  prevention & control
Epidemiologic Methods
Hypothermia, Induced / methods
Intraoperative Care / methods
Middle Aged
Perfusion / methods
Treatment Outcome

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