Ascending aortic aneurysm: propensity score matching analysis of hemiarch and non-hemiarch replacement
Open Access
- 18 November 2020
- journal article
- Published by Silicea - Poligraf, LLC in Russian Journal of Cardiology
- Vol. 25 (10), 3887
- https://doi.org/10.15829/1560-4071-2020-3887
Abstract
Aim. To compare the shortand medium-term outcomes of hemiarch and nonhemiarch replacement for ascending aortic aneurysm (AAA).Material and methods. The study included 151 patients with non-syndromic AAA who underwent an elective replacement. Patients were divided into two groups: group 1 (non-hemiarch, n=40) — standard ascending aortic replacement; group 2 (hemiarch, n=111) — ascending aortic replacement with the hemiarch anastomosis in conditions of moderate hypothermia and circulatory arrest with unilateral antegrade cerebral perfusion. To eliminate systematic differences between the compared groups, the propensity score matching (PSM) method was used.Results. Before PSM, there were no significant intergroup differences in the incidence of neurological complications, myocardial infarction, prolonged ventilation, or acute kidney injury. Bleeding-related reoperation rates and hospital mortality significantly differed between groups. After pseudo-randomization between the non-hemiarch and hemiarch groups, there were no significant differences in the incidence of neurological events, myocardial infarction, prolonged ventilation, reoperations for bleeding, acute renal injury, and hospital mortality. Median-term survival and freedom from aortic reoperations also did not show significant intergroup differences.Conclusion. Hemiarch replacement for AAA does not lead to an increase in the incidence of postoperative complications, as well as the risk of shortand mediumterm mortality compared with non-hemiarch.Keywords
This publication has 18 references indexed in Scilit:
- Elective primary aortic root replacement with and without hemiarch repair in patients with no previous cardiac surgeryThe Journal of Thoracic and Cardiovascular Surgery, 2017
- Results of radical reconstruction of thoracic aortic aneurysms using hemi-arch techniqueKardiologiya i serdechno-sosudistaya khirurgiya, 2016
- The addition of hemiarch replacement to aortic root surgery does not affect safetyThe Journal of Thoracic and Cardiovascular Surgery, 2015
- The new technique of unilateral antegrade cerebral perfusion during aortic arch surgeryKardiologiya i serdechno-sosudistaya khirurgiya, 2015
- Generation of human vascular smooth muscle subtypes provides insight into embryological origin–dependent disease susceptibilityNature Biotechnology, 2012
- Should the proximal arch be routinely replaced in patients with bicuspid aortic valve disease and ascending aortic aneurysm?The Journal of Thoracic and Cardiovascular Surgery, 2011
- 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic DiseaseJournal of the American College of Cardiology, 2010
- Thoracic Aortic Aneurysm and DissectionJournal of the American College of Cardiology, 2006
- Secondary heart field contributes myocardium and smooth muscle to the arterial pole of the developing heartDevelopmental Biology, 2005
- Reoperations on the Aortic Root and Ascending AortaThe Annals of Thoracic Surgery, 1997