Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34084
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.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34084
DOI: 10.1016/j.athoracsur.2022.09.020
ORCID: 
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)

24
checked on Apr 19, 2024

Google ScholarTM

Check


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