Mortality and Survival in Aortic Arch Surgeries with Preservation of Supra-aortic Vessels: Thirteen Years of Experience
Paula Ferraz de Oliveira
Gustavo Luiz Gouvêa de Almeida Junior
Fabrício Braga da Silva
Mauro Paes Leme de Sá
Valdo José Carreira
Bruno Soares da Silva Rangel
Sicilia Pacheco e Silva
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 mediumterm 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)
Keywords: Aorta, Thoracic / physiopathology; Aorta, Thoracic / surgery; Mortality; Aortic Aneurysm / surgery; Survivorship (Public Health); Comparative Study.