IJCS | Volume 31, Nº5, September / October 2018

474 Oliveira et al. Mortality and survival in aortic arch surgeries Int J Cardiovasc Sci. 2018;31(5)466-482 Original Article these percentages were 25.6%, 26.8%, 34.6% and 50.9%, respectively. Five-year mortality was significantly different between the groups (Table 4). Overall cardiovascular mortalitywas 20.7% in groupA and 32.9% in group B, with no statistic difference between the groups (Graph 3). Discussion Antegrade cerebral perfusion is recognized as the best method to protect the brain against ischemic injuries, regardless of the surgical technique or strategy Table 4 - Cardiovascular mortality by techniques for aortic arch reconstruction (partial preservation of aortic arch and supra-aortic vessels, Group A or conventional surgeries, Group B) Outcome Group A Group B p N n(%) N n(%) 30-day mortality 3 10.3% 21 25.6% 0.086 In-hospital mortality 4 13.8% 22 26.8% 0.154 2-year mortality 4 14.8% 27 34.6% 0.052 5-year mortality 5 22.7% 27 50.9% 0.024 Global mortality 6 20.7% 27 32.9% 0.215 adopted for the aortic arch approach. Also, moderate hypothermia (approximately 25ºC) is not associated with neurologic sequalae. Total aortic arch replacement, as in group A, was performed under selective cerebral perfusion and moderate hypothermia since, as reported by Kazui et al., 9 selective cerebral perfusion is a reliable technique for brain protection and facilitates time-consuming total arch replacement. In group B, many conventional techniques for aortic arch reconstruction were performed, with a wide theoretical base and practical applicability. Brain Graph 3 - Cardiovascular survival curve in patients who underwent partial preservation of aortic arch and supra-aortic vessels (Group A, n = 29) and patients who underwent conventional surgical techniques for aortic arch reconstruction (Group B, n = 82). Group A Group B Survival Time Log rank - p = 0.403