Materials and Methods
The analysis includes all consecutive patients who underwent elective aortic arch aneurysm surgery in the Department of Cardiac Surgery, Upper Silesian Medical Center of the Medical University of Silesia from January 2010 until December 2020. Patients were referred for elective surgery according to current guidelines. Following indications for aortic arch surgery were identified: aortic arch aneurysm, chronic aortic dissection, and saccular aneurysm of aortic arch.
Patients with coexisting heart disease, requiring additional surgical procedures, were not excluded. However, excluded were patients with acute type A aortic dissection undergoing emergency surgery.
Primary surgery outcome measure was mortality, ascertained from 1 or more of the following: patient’s visit in the outpatient clinic, telephone contact with the patient or patient’s relatives, National Registry of Cardiac Surgical Procedures (Krajowy Rejestr Operacji Kardiochirurgicznych) (www.krok.csioz. gov.pl.) Krajowy Rejestr Operacji Kardiochirurgicznych registry contains the mortality data obtained from the National Health Fund (Narodowy Fundusz Zdrowia). Death from all causes was included into the analysis.
The local Institutional Review Board opinion was requested. They decided that the follow-up was not a medical experiment, and therefore, their approval was not required (decision number KNW/0022/KB/284/17 dated 12 December 2017).
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.