Introduction
Isolated aortic arch aneurysm is a condition rarely encountered in cardiac surgery [1]. Usually, aortic arch aneurysms co-exist with the enlargement of adjacent segments of ascending and/or descending aorta (Fig1A). Saccular aneurysms with their limited extent are the exception. Surgical treatment of isolated aortic arch aneurysms, or those co-existing with diseases of other segments of the aorta is complex and technically demanding, particularly when classical surgical techniques (Fig.1A) have to be supplemented with endovascular procedures. As aortic arch surgery requires temporary circulatory arrest, adequate protection of the central nervous system is of paramount importance to avoid complications associated with brain ischemia [2]. Current guidelines recommend elective surgery, when the diameter of the aortic arch measures ≥5.5 cm or this diameter increases at least 0.5 cm per year. In patients with connective tissue diseases surgery is recommended when the diameter of the aortic arch measures ≥4.5 cm or this diameter increases at least 0.2 cm per year [3].
Aim of this study was to review the 10-year outcomes of elective surgery for aortic arch aneurysm.