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.