Abstract
Background Open aortic arch surgery is a complex cardiac surgical
procedure. Aims We have reviewed the 10-year outcomes of elective
surgery for aortic arch aneurysm in the Cardiac Surgery Department,
Upper-Silesian Medical Center of the Medical University of Silesia.
Methods The analysis includes all patients who underwent elective aortic
arch surgery at our institution from January 2010 to December 2020. To
assess the impact of the surgical learning curve the study population
was divided into group A consisting of patients operated during the
first 5 years, and group B, including patients operated during the
subsequent 5 years. Both groups were compared with regard to baseline
characteristics, scope of the surgery, operative and postoperative data
as well as morbidity and mortality. Results Eighty-six elective aortic
arch surgeries were performed during the analyzed period, including 25
patients (29%) in group A and 61 patients in group B (71%). The
hemiarch procedure was more frequently performed in group A (17
patients, 68%) in comparison to group B (21 patients, 34%) (P=0.008).
More procedures on the descending aorta were performed in group B (27
patients, 44%) than in group A (6 patients, 24%) (P=0.09). Stroke was
recorded in 6 patients (20%) from group A and 5 patients (8.2%) from
group B (P=0.002). Five-year survival was 60±9.8% for group A, and
81±6.2% for group B (log-rank test, P=0.003). Conclusions After
completion of the learning curve, open aortic arch surgery is associated
with acceptable early mortality, low incidence of stroke, and high
5-year survival rate.