Outcomes of reoperation for total arch replacement combined with frozen elephant trunk after previous cardiovascular surgery

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 car-diovascular 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.(c) 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Automated summary

This study reviewed the strategy and outcomes of aortic arch replacement (TAR) combined with frozen elephant trunk (FET) after previous cardiovascular surgery. The study found that elective surgery had a lower 30-day mortality rate and shorter hospital stay, but had no impact on long-term survival rate.