Outcomes of circulatory arrest procedures for the treatment of thoracic aortic disease at a veterans facility

BackgroundThe outcomes of thoracic aortic surgery involving hypothermic circulatory arrest at a US Department of Veterans Affairs medical center were evaluated.MethodsUsing the Veterans Affairs Continuous Improvement in Cardiac Surgery Program, all thoracic aortic operations performed with hypothermic circulatory arrest between December 1999 and December 2009 were identified (n = 24). Operative mortality and morbidity were evaluated, and survival was assessed by using the Kaplan-Meier method.ResultsAortic dissection was the underlying disease in 10 patients (42%). Full or hemiarch aortic repair was performed in 16 patients (67%); of these operations, 3 (13%) involved elephant trunk repair. There was 1 operative death (4%). Four patients (17%) had strokes (all but 1 fully recovered), and 1 (4%) had renal failure. The survival rate was 90% at 1 year and 67% at 3 years.ConclusionsDespite the magnitude and risk of thoracic aortic surgery involving hypothermic circulatory arrest, good outcomes can be achieved when such surgery is performed at an experienced Veterans Affairs center.