Please use this identifier to cite or link to this item:
Title: Branch-first Continuous Perfusion Aortic Arch Replacement: Midterm Results.
Austin Authors: Sharma, Varun J;Kanagarajah, Abbie R;Seevanayagam, Siven ;Kim, Michelle;Matalanis, George 
Affiliation: Thoracic Surgery
Cardiac Surgery
Surgery (University of Melbourne)
Issue Date: Aug-2023
Date: 2022
Publication information: The Annals of Thoracic Surgery 2023-08; 116(2)
Abstract: Aortic arch surgery necessitates interruption of perfusion, thus conferring higher morbidity and mortality compared with other aortic surgery. This report describes a branch-first continuous perfusion aortic arch replacement (BF-CPAR) technique that overcomes these shortcomings and describes midterm results with this technique. This report represents the corresponding author's 15-year experience with BF-CPAR, which involves preliminary mobilization and branch reconstruction before circulatory arrest by using a modified trifurcation graft. Demographic, procedural, and outcome (mortality, reintervention, morbidity, and stroke) were analyzed with Kaplan-Meier and Cox regression. Over 15 years (July 2005-February 2021), 155 patients underwent BF-CPAR, at a median age of 66.8 years, 106 (68.3%) on an elective basis and 49 (31.6%) on an emergency basis. There were no aortic deaths after the first postoperative year, thereby resulting in a 1- and 10-year freedom from aortic death constant at 95.6% in patients undergoing elective BF-CPAR and 93.3% in patients undergoing emergency BF-CPAR patients, respectively. Freedom from reintervention on the operated segment at 5 and 9 years was 93.2% and 93.2% in patients undergoing elective cases and 97.1% and 91.4% in emergency cases, respectively. The 10-year freedom from any aortic reintervention was 72.8% in elective patients and 29.2% in emergency patients; there were 38 reinterventions, 76.3% (n = 29/38) done for progression of aneurysmal or dissection disease, of which 79.3% (n = 23/29) were completed endovascularly. Freedom from cerebrovascular-related events at 5 and 10 years was 90.3% and 82.6% in patients undergoing elective BF-CPAR and 75.4% for both time points in patients undergoing emergency BF-CPAR, respectively. BF-CPAR has excellent 10-year results for elective and emergency cases of arch replacement.
DOI: 10.1016/j.athoracsur.2022.09.020
Journal: The Annals of Thoracic Surgery
Start page: 280
End page: 286
PubMed URL: 36152878
ISSN: 1552-6259
Type: Journal Article
Subjects: Aorta, Thoracic/surgery
Blood Vessel Prosthesis Implantation/methods
Postoperative Complications/etiology
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Apr 19, 2024

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.