Pulmonary complications are the most common complications following Descending Thoracic (DTAA) and Thoracoabdominal Aortic Aneurysm (TAAA) repairs. The study aims to assess the relationship of postoperative pulmonary complications with short and long- term mortality. Background Retrospective review of prospectively collected data from 206 consecutive patients who underwent DTAA or TAAA repair between 1998 and 2011. Methods
Results Mortality Hospital mortality rate= 8.3% (n=17). Long term mortality rate =29.2% (n=57).mean follow-up 5.5 ± 3.5 years *Pulmonary complications Prolonged (48 hours) Ventilatory Support (PVS) =42.7% (n=83), tracheostomy = 11.7% (n=24) Gender Distal aortic perfusion (DAP)= 55.8% (n=115). Deep hypothermic circulatory arrest (DHCA)= 25.7% (n=53) Perfusion technique Total=206 patients mean age=63.1±12.4. Male=61.7%(n=127). Female= 38.3% (n=79) *At least one pulmonary complication occurred in 102 patients (49.5%). Type of Surgery Thoracoabdominal aortic aneurysms (TAAA)=71.8% (n=148), Descending Thoracic Aortic Aneurysm (DTAA)=28.2% (n=58)
Time in mins Mean Cardio Pulmonary Bypass time99±89 Mean cross clamp time50±21 Mean Deep Hypothermic Circulatory Arrest time24±12 Seven year survival with complicationwithout complication PVS52 ± 6.6%76.3 ± 5.2% Tracheostomy51.0 ± 12.6%67.6 ± 4.4% Univariable analysis revealed Prolonged ventilatory support (PVS) was associated with increased long-term mortality (p<0.01), tracheostomy was associated with increased hospital and long-term mortality (p<0.01, p0.05 respectively) Results
0 2 4 6 8 10 12 14 prolonged ventilatory supportTracheostomy Results Seven year survival rate for patients requiring PVS vs. those who did not was 52±6.6% vs.76.3±5.2%. Seven year survival for patients with tracheostomy vs. those without was 51.0±12.6% vs. 67.6±4.4%.
Tracheostomy was a significant predictor of short and long-term mortality. Prolonged ventilatory support was a significant predictor of long-term mortality, following DTAA and TAAA repairs. These complications adversely affected the long-term survival of patients after DTAA and TAAA repair. Conclusion