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.