Why the study?
Incidentally discovered severe calcified ascending aorta is a major challenge during cardiac surgery, prompting evaluation of outcomes with additional replacement of the calcified ascending aorta.
Does the additional replacement of an incidentally discovered severe calcified ascending aorta during cardiac surgery increase the risk of neurologic adverse events or mortality in patients undergoing cardiac surgery?
Does the additional replacement of an incidentally discovered severe calcified ascending aorta during cardiac surgery increase the risk of neurologic adverse events or mortality in patients undergoing cardiac surgery?
Additional replacement of an incidentally discovered severe calcified ascending aorta during cardiac surgery does not significantly increase the risk of neurologic adverse events or 30-day mortality compared to matched controls.
Background Incidentally discovered severe calcified ascending aorta (CAA) is a major challenge faced by surgeons during cardiac surgery. The aim of this study was to evaluate the outcome in patients undergoing cardiac surgery in this condition with the additional replacement of the CAA. Methods A retrospective study on a cohort of 74 patients (28.4% females; mean age: 73 ± 7 years) underwent cardiac surgery and initial replacement of an incidentally discovered CAA using moderate hypothermic circulatory arrest. A control group was matched according to age, gender, and procedure. Results No significant differences were noted with regard to preoperative risk factors. Due to the additional replacement of CAA, the extracorporeal circulation and cross-clamping time were significantly longer in the study group (p < 0.001). Postoperatively, no significant differences in complications were observed between the groups. There was no significant difference in regard to incidence of neurologic adverse events (5.4 vs. 2.7%; p = 0.68) or 30-day mortality (6.7 vs. 4.1%; p = 0.72). Conclusion Our study showed that the initial replacement of incidental CAA in patients undergoing cardiac surgery was not associated with increased risks for neurologic adverse events and mortality.
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Salem et al. (2019) studied this question.
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