Technical advances improved outcome in patients undergoing surgery of the ascending aorta and/or aortic arch: ten years experience

Krähenbühl, Eva; Immer, Franz F.; Stalder, Mario; Englberger, Lars; Eckstein, Friedrich S.; Schmidli, Jürg; Carrel, Thierry

doi:10.1016/j.ejcts.2008.04.051

Cited by 23 publications

(6 citation statements)

References 18 publications

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“…In particular, aspects of cerebroprotection by total body cooling or isolated cerebral perfusion, cannulation strategies, and aggressive surgical repair have been advocated. The suggestion that it is these operative techniques [21] that have improved outcomes is contentious, given the wide range of techniques that remain in use.…”

Section: Recently the International Registry Of Acute Aortic Dissectmentioning

confidence: 98%

Contemporary Results Following Surgical Repair of Acute Type A Aortic Dissection (AAAD): A Single Centre Experience

Campbell-Lloyd

Mundy

Pinto

et al. 2010

Heart, Lung and Circulation

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Section: Recently the International Registry Of Acute Aortic Dissectmentioning

confidence: 98%

Contemporary Results Following Surgical Repair of Acute Type A Aortic Dissection (AAAD): A Single Centre Experience

Campbell-Lloyd

Mundy

Pinto

et al. 2010

Heart, Lung and Circulation

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“…1,2 A recent study from The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database examining outcomes in 45,894 patients undergoing ascending aorta replacement (with or without root), with or without arch replacement, from 2004 to 2009 found nonelective case status to be the strongest predictor of major morbidity or mortality, although other comorbid conditions such as severe chronic lung disease, chronic kidney disease, and cerebrovascular disease also predicted an increased risk. 2 Frailty, defined as a state of increased vulnerability to stressors caused by deterioration across multiple physiologic systems, is an independent risk factor for in-hospital mortality, reduced midterm survival, and prolonged residential care requirements in cardiac surgery.…”

mentioning

confidence: 99%

Frailty and risk in proximal aortic surgery

Ganapathi

Englum

Hanna

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Objectives Although frailty has recently been examined in various populations as a predictor of morbidity and mortality, its effect on thoracic aortic surgery outcomes has not been studied. The objective of the present study was to evaluate the role of frailty in predicting postoperative morbidity and mortality in patients undergoing proximal aortic replacement surgery. Methods A retrospective analysis of a prospectively maintained database was performed for all patients undergoing elective and nonelective proximal aortic operations (root, ascending aorta, and/or arch) at a single-referral institution from June 2005 to December 2012. A total of 581 patients underwent proximal aortic surgery, of whom 574 (98.8%) were included in the present analysis; 7 were excluded because of incomplete data. Frailty was evaluated using an index consisting of age > 70 years, body mass index < 18.5 kg/m2, anemia, history of stroke, hypoalbuminemia, and total psoas volume in the bottom quartile of the population. One point was given for each criterion met to determine a frailty score of 0 to 6. Frailty was defined as a score of ≥ 2. Risk models for length of stay > 14 days, discharge to other than home, 30-day composite major morbidity, 30-day composite major morbidity/mortality, and 30-day and 1-year mortality were calculated using multivariate regression modeling. Results Of the 574 patients, 148 (25.7%) were defined as frail (frailty score ≥ 2). The unadjusted 30-day/in-hospital and long-term outcomes were significantly worse for the frail versus nonfrail patients in all but 1 of the outcomes analyzed; no difference was found in the 30-day readmission rates between the 2 groups. In the multivariate model, a frailty score of ≥ 2 was associated with discharge to other than home and 30-day and 1-year mortality. Conclusions Frailty, as defined using a 6-component frailty index, can serve as an independent predictor of discharge disposition and early and late mortality risk in patients undergoing proximal aortic surgery. These frailty markers, all of which are easily assessed preoperatively, could provide valuable information for patient counseling and risk stratification before proximal aortic replacement.

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“… 11 , 12 Despite improved protection to the brain and myocardium as a result of technical advancements in thoracic surgery, mortality and morbidity rates remain elevated. 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

Outcomes in Patients Undergoing Surgical Aortic Valve Replacement With vs Without a Preoperative Heart Team Assessment

et al. 2023

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Technical advances improved outcome in patients undergoing surgery of the ascending aorta and/or aortic arch: ten years experience

Cited by 23 publications

References 18 publications

Contemporary Results Following Surgical Repair of Acute Type A Aortic Dissection (AAAD): A Single Centre Experience

Contemporary Results Following Surgical Repair of Acute Type A Aortic Dissection (AAAD): A Single Centre Experience

Frailty and risk in proximal aortic surgery

Outcomes in Patients Undergoing Surgical Aortic Valve Replacement With vs Without a Preoperative Heart Team Assessment

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