Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery · 2025
[Prosthetic repair of the ascending aorta in patients with normal and variant anatomy of the brachiocephalic trunk].
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Petrakova E A, Panfilov D S, Lelik E V, Kozlov B N
Аннотация
OBJECTIVE: To comparatively analyze early results of surgical treatment of patients with aneurysms of the ascending aorta in normal and variant anatomy of the brachiocephalic trunk.
PATIENTS AND METHODS: Our retrospective study included a total of 259 patients operated on for ascending aortic aneurysms. Depending on the anatomy of the brachiocephalic trunk (BCT), the patients were divided into two groups. Group I consisted of 202 patients with normal anatomy of the BCT and Group II comprised 57 patients having variant anatomy of the BCT, with the BCT and left common carotid artery originating from the aorta in a solitary-ostium manner. We analyzed both intra- and postoperative data.
RESULTS: The duration of artificial circulation and circulatory arrest with antegrade cerebral perfusion was comparable in patients of both groups. Analyzing the course of the postoperative period revealed 11 (5.4%) neurological events in Group I patients and 2 (3.5%) neurological events in Group II patients (p=0.542). Prolonged pulmonary ventilation was required in 14 (6.9%) Group I patients and in 1 (1.7%) Group II patient (p=0.142); resternotomy for hemorrhagic complications was required in 6 (2.9%) and 4 (7.01%) Group I and Group II patients, respectively (p=0.170). Hospital mortality in Group I amounted to 7 (3.4%) patients, with no lethality in Group II (p=0.152).
CONCLUSION: The anatomical structure of the brachiocephalic trunk is not a factor influencing the result of prosthetic repair of the ascending aorta ('hemiarch').
PATIENTS AND METHODS: Our retrospective study included a total of 259 patients operated on for ascending aortic aneurysms. Depending on the anatomy of the brachiocephalic trunk (BCT), the patients were divided into two groups. Group I consisted of 202 patients with normal anatomy of the BCT and Group II comprised 57 patients having variant anatomy of the BCT, with the BCT and left common carotid artery originating from the aorta in a solitary-ostium manner. We analyzed both intra- and postoperative data.
RESULTS: The duration of artificial circulation and circulatory arrest with antegrade cerebral perfusion was comparable in patients of both groups. Analyzing the course of the postoperative period revealed 11 (5.4%) neurological events in Group I patients and 2 (3.5%) neurological events in Group II patients (p=0.542). Prolonged pulmonary ventilation was required in 14 (6.9%) Group I patients and in 1 (1.7%) Group II patient (p=0.142); resternotomy for hemorrhagic complications was required in 6 (2.9%) and 4 (7.01%) Group I and Group II patients, respectively (p=0.170). Hospital mortality in Group I amounted to 7 (3.4%) patients, with no lethality in Group II (p=0.152).
CONCLUSION: The anatomical structure of the brachiocephalic trunk is not a factor influencing the result of prosthetic repair of the ascending aorta ('hemiarch').