Contemporary results of hemiarch replacement
| Autor: | Mario Gaudino, Monica Munjal, Leonard N. Girardi, Ivancarmine Gambardella, Lucas B. Ohmes, Cristiano Spadaccio, Christopher Lau, Antonino Di Franco, Fawad Hameedi |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Blood Vessel Prosthesis Implantation 03 medical and health sciences Aortic aneurysm Postoperative Complications 0302 clinical medicine Aneurysm medicine Humans Myocardial infarction Survival rate Aorta Dialysis Aged Retrospective Studies Aged 80 and over Aortic dissection business.industry General Medicine Odds ratio Middle Aged medicine.disease Confidence interval Aortic Aneurysm Blood Vessel Prosthesis Surgery Aortic Dissection Treatment Outcome 030228 respiratory system Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 52:333-338 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezx071 |
| Popis: | Objectives Our goal was to report on early and midterm outcomes of hemiarch replacement performed in a high-volume centre. Methods We extrapolated hemiarch replacements from our institutional aortic database. We also analysed the impact of aortic disease (dissection vs aneurysm) on the outcomes of de novo hemiarch replacement. Results A total of 756 patients underwent hemiarch replacement between 1997 and 2016. After elimination of cases involving the aortic root/valve and redo cases, we identified 426 cases of de novo -isolated hemiarch replacement (369 aneurysms and 57 dissections). Overall operative mortality was 3.1% (13 of 426). The most frequent complications were respiratory failure requiring tracheostomy (11 of 426, 2.6%) and renal failure requiring dialysis (7 of 426, 1.6%). On regression analysis, previous myocardial infarction was the only independent predictor of major adverse events (odds ratio 3.14; 95% confidence interval 1.36-7.22; P = 0.007). Operative mortality was 5.3% (3 of 57) for dissections and 2.7% (10 of 369) for aneurysms ( P = 0.29). The postoperative need for tracheostomy and for new dialysis was more frequent in the dissection group (4 of 57 vs 7 of 369; P = 0.02 and 3 of 57 vs 4 of 369; P = 0.02, respectively). At 5 years, the overall survival rate was 72.5% (95% confidence interval 66.4-78.6%), and there was no difference in survival and risk of reoperation between the 2 groups ( P = 0.97). Conclusions In high-volume centres, aortic hemiarch replacement can be performed with excellent results. The aortic disease only partially affects the early and midterm outcomes. |
| Databáze: | OpenAIRE |
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