ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Factors affecting long-term survival of patients undergoing aortic surgery using the antegrade selective cerebral perfusion technique
Anıl Özen1, Garip Altıntaş1, Ümit Kervan1, Ertekin Utku Ünal1, Metin Yılmaz1, Selin Özen2, Zafer İşcan1, Mehmet Ali Özatik3
1Department of Cardiovascular Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
2Department of Physical Medicine and Rehabilitation, Medical Faculty of Ankara University, Ankara, Turkey
3Department of Cardiovascular Surgery, Acıbadem Eskişehir Hospital, Eskişehir, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.8205
Background: This study aims to investigate the factors effecting long-term survival of patients undergoing ascending and arcus aortic aneurysm repair and/or dissection surgery using the antegrade selective cerebral perfusion (ASCP) technique.

Methods: Between January 2000 and December 2008, 154 operative survivors of 177 patients (89 males, 65 females; mean age 54.5±12.4 years; range 20 to 84 years) w ho were operated in our clinic using the ASCP technique and discharged from t he hospital were included in the study. Eighty-four patients (54.5%) underwent dissection repair, while 70 (45.5%) underwent aneurysm repair. Patients who survived during the follow-up period were classified as group 1 and those who died were classified as group 2.

Results: The mean follow-up period was 50.5±26.8 (range 3-106) months. Ten patients died during the follow-up period. The mortality rate was 6.49%. The length of intensive care unit stay (p<0.05), and blood and fresh frozen plasma (FFP) transfusion volume (p<0.05 for both) were higher in group 2. The length of intensive care unit stay was longer in patients with comorbid coronary artery disease (p<0.05), bleeding, cardiac tamponade (p<0.005), prolonged ventilation (p<0.001), and those on inotropic support (p<0.001). Logistic regression analysis of the variables with significant differences between the two groups revealed that the blood transfusion was an independent predictor for long-term survival (OR 1.33, 95% CI; 1.02-1.74, p=0.035). The probability of actuarial survival was found to be 98%, 94.8% and 93.5% at one, five and ten years, respectively.

Conclusion: Prolonged length of intensive care stay along with associated risk factors may affect the long-term survival of the patients operated using the ASCP technique. These risk factors should be established and controlled, while vascular risk factors should also be considered to achieve a long-term survival.

Keywords : Aortic aneurysm; dissecting aneurysm; follow-up studies; morbidity; mortality
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