Key result
Non-elective total arch replacement with frozen elephant trunk had higher 30-day mortality than elective surgery, but similar 5-year survival without aortic events (72.9% vs 72.3%, P=0.955).
Why the study?
Aortic arch replacement combined with frozen elephant trunk is a high-risk reoperation after previous cardiovascular surgery, prompting a review of surgical strategy and outcomes.
Does elective versus non-elective reoperation for TAR combined with FET after previous cardiovascular surgery improve outcomes?
Cohort (n=63)
Does elective versus non-elective reoperation for TAR combined with FET after previous cardiovascular surgery improve outcomes?
Absolute Event Rate: 72.9% vs 72.3%
p-value: p=0.955
Elective reoperation for TAR with FET after previous cardiovascular surgery is associated with lower 30-day mortality and shorter hospital stays compared to non-elective surgery, though long-term survival without reintervention is similar.
BACKGROUND: Aortic arch replacement(TAR) combined with frozen elephant trunk (FET) technique is a high-risk operation after previous cardiovascular surgery. The aim of the study was to review our strategy and outcomes in this cohort. METHOD: Data were reviewed for patients who underwent TAR combined with FET after previous cardiovascular surgery from January 2010 to December 2020. The patients were divided into elective group and non-selective group. RESULTS: 63 eligible patients were divided into elective(n = 44) and non-elective(n = 19) groups. The interval between two operations was shorter in non-elective group than elective groups (P = 0.001). The indication for reoperation was different in two groups (P = 0.000), however, the type of reoperations has no differences. Cardiopulmonary bypass time was shorter in elective group than non-elective group (P = 0.000). The over-all 30-day mortality rate was 17.5%, and it was higher in non-elective group (P = 0.013). The 24h drainage increased in non-elective group (P = 0.001) as well as re-explore rate for bleeding (P = 0.022). Postoperative hospital stay prolonged in non-elective group (P = 0.002). However, rates of survival without further aortic events were 72.3 ± 7.1% in elective group, 72.9 ± 13.5% in non-elective group at 5 years, respectively (P = 0. 955). CONCLUSION: Reduced 30-day mortality and shortened post-operative hospital stay was observed in elective group, however, long-term survival rate without reintervention were not affected.
No takes yet. Share an insight, caveat, or question.
Sun et al. (2022) conducted a cohort in Previous cardiovascular surgery requiring total arch replacement with frozen elephant trunk (n=63). Non-elective surgery vs. Elective surgery was evaluated on Survival without further aortic events at 5 years (p=0.955). Non-elective total arch replacement with frozen elephant trunk had higher 30-day mortality than elective surgery, but similar 5-year survival without aortic events (72.9% vs 72.3%, P=0.955).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: