Introduction:
We present group of patients operated due to aortic pathology at our department from June 2002 to December 2006.
Material and methods: In this period total of 187 patients were operated due to thoracic aorta pathology at our department, 48 of them under acute condition (aortic dissection type A). Replacement of ascending aorta (AAR) with or without operation of aortic root (ARR) as a single procedure was performed in 107 cases, in 58 cases together with aortic arch and in 22 with construction of elephant trunk (ET) or “Frozen ET”. 33 patients underwent aortic valve spearing operation.
Results: Our group consists of 130 male and 57 (44%) female patients average age of 56,8± 16,2 (range 18-80years). 30-day mortality was 7,5% (14 pts), from this for acute 16,6% (8 pts) and 4,3% (6 pts) for elective. Twelve patients were revisited due to bleeding, three due to abdominal ischemia, 8 suffer from mediastinitis, 57 have period of atrial fibrillation, 13 mild and 10 severe neurological complications from which only four remain permanent. During follow up (2month to 4 years) another 16 pts die. Actuarial four years survival is 87,1% for elective and 75,0% for acute operations. From 36 long surviving acute patients 13 should be considered as cured, 9 received additional intervention (operation) and 14 are annually evaluated.
Conclusion: Elective operation except chronic dissections and endocarditis bring good results with minimum recurrence of disease. For acute dissections and younger patients a simple replacement of ascending aorta carry a potential risk of dilatation of aortic arch with need of reoperation with higher risk. Frozen ET technique seems to be a good and technically feasible alternative for such patients. Careful postoperative evaluation of patients in outpatient clinic is crucial for achieving good long-term results.
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