Mortality and Survival in Aortic Arch Surgeries with Preservation of Supra-aortic Vessels: Thirteen Years of Experience

• Published in: International journal of cardiovascular sciences Vol. 31; no. 5; pp. 466 - 482
• Main Authors: Oliveira, Paula Ferraz de, Almeida Junior, Gustavo Luiz Gouvêa de, Silva, Fabrício Braga da, Sá, Mauro Paes Leme de, Carreira, Valdo José, Rangel, Bruno Soares da Silva, Silva, Sicilia Pacheco e
• Format: Journal Article
• Language: English; Portuguese
• Published: Sociedade Brasileira de Cardiologia 01-10-2018
• Subjects: CARDIAC & CARDIOVASCULAR SYSTEMS; Survivorship (Public Health); Aorta, Thoracic / physiopathology; Comparative Study; Aorta, Thoracic / surgery; Mortality; Aortic Aneurysm / surgery
• ISSN: 2359-5647; 2359-5647
• DOI: 10.5935/2359-4802.20180069

Abstract Background: The aortic arch diseases exhibit high morbidity and mortality rates. Some surgical strategies recommend partial preservation of the aortic arch and the supra-aortic vessels, but the immediate and medium-term mortality rates of patients undergoing this surgical strategy is uncertain. Objectives: To compare overall mortality and mid- term survival curve of patients undergoing surgical strategy of partial preservation of the aortic arch and supra-aortic vessels (group A) compared to conventional strategies of the aortic arch approach (group B); to assess cardiovascular mortality over time. Methods: Descriptive and retrospective study of the medical records of patients undergoing aortic arch repair surgery between February 2000 and July 2013. We analyzed 111 patients, 29 in group A and 82 in group B. The overall survival and survival from cardiovascular events were assessed by Kaplan-Meier test. Results: In- hospital mortality from any cause was 31% in group A and 29.3% in group B. At 1 year, 2 year, and 5 year general survival was similar between the groups. In-hospital, 2 years and 5 years mortality from cardiovascular causes was 13.8%, 14.8%, e 22.7% in group A and 26.8%, 34.6% e 50.9% in group B. The difference between the groups in 5 years showed statistical significance (p = 0.0234). Survival from cardiovascular causes in 2 years and 5 years was 85.2% and 77,3% in group A and 65.4% and 49,1% in group B. Occurrence of urgent and emergency procedures were greater in group A, but without statistical significance. Conclusions: There was no difference in all-cause mortality over time between the groups. Group A showed lower cardiovascular mortality at 5 years than group B. (Int J Cardiovasc Sci. 2018;31(5)466-482)