Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34084
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dc.contributor.authorSharma, Varun J-
dc.contributor.authorKanagarajah, Abbie R-
dc.contributor.authorSeevanayagam, Siven-
dc.contributor.authorKim, Michelle-
dc.contributor.authorMatalanis, George-
dc.date2022-
dc.date.accessioned2023-10-25T06:19:13Z-
dc.date.available2023-10-25T06:19:13Z-
dc.date.issued2023-08-
dc.identifier.citationThe Annals of Thoracic Surgery 2023-08; 116(2)en_US
dc.identifier.issn1552-6259-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/34084-
dc.description.abstractAortic 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.en_US
dc.language.isoeng-
dc.titleBranch-first Continuous Perfusion Aortic Arch Replacement: Midterm Results.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleThe Annals of Thoracic Surgeryen_US
dc.identifier.affiliationThoracic Surgeryen_US
dc.identifier.affiliationCardiac Surgeryen_US
dc.identifier.affiliationSurgery (University of Melbourne)en_US
dc.identifier.doi10.1016/j.athoracsur.2022.09.020en_US
dc.type.contentTexten_US
dc.identifier.pubmedid36152878-
dc.description.volume116-
dc.description.issue2-
dc.description.startpage280-
dc.description.endpage286-
dc.subject.meshtermssecondaryAorta, Thoracic/surgery-
dc.subject.meshtermssecondaryBlood Vessel Prosthesis Implantation/methods-
dc.subject.meshtermssecondaryPostoperative Complications/etiology-
item.languageiso639-1en-
item.cerifentitytypePublications-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
crisitem.author.deptEndocrinology-
crisitem.author.deptCardiac Surgery-
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