16th International congress of update in cardiology and cardiovascular surgery, Ankara, Türkiye, 30 Ekim - 01 Kasım 2020, sa.814, ss.122-123
This study aimed to investigate retrospectively the early and midterm results of patients who were operated for aortic arch pathologies.
Between February 2007 and October 2016, 211 patients who underwent aortic arch surgery were included in the study and the data were
analyzed retrospectively. Preoperative, intraoperative and postoperative data were investigated; mortality and morbidity results were
evaluated and analyzed statistically. Of the patients participating in the study, 73 (34.6%) were female and 138 (65.4%) were male. The
mean age was 58.2 ± 13.4 years. 64 patients (30.3%) were urgent and 147 patients (69.7%) were operated under elective conditions. 54
patients (25.6%) were treated with acute dissection, and 182 patients (86.3%) with aortic aneurysm. Hemiarch replacement was performed
in 179 patients (84.8%) and total arch replacement was performed in 32 patients (15.2%).
The mortality rate was 11.8% for the first 30 days postoperatively and 13.3% for the hospitalization period. We observed temporary
neurological dysfunction in 2 patients (0.9%) and permanent neurological dysfunction in 5 patients (2.4%) postoperatively. The 30-day
survival rate was 98.3% among patients who underwent hemiarch replacement, while this rate was 58.1% among patients who underwent
total arch replacement (p <0.001).
Total arch replacement has worse mid and early outcomes compared to hemiarch replacement, especially in emergency cases, in terms of
mortality and morbidity. We believe that avoiding total arch replacement surgery to the maximum extent and limiting the surgery to
aggressive hemiarch replacement will be more appropriate and meaningful.