Multi-confocal fluorescence correlation spectroscopy.
1. Heart Surg Forum. 2018 Jun 18;21(4):E263-E268. doi: 10.1532/hsf.2004.
Perioperative Outcomes of Repeated Open Surgery on the Thoracic Aorta.
Shim H(1), Jeon CS, Park PW, Kim WS, Lee YT, Jeong DS, Cho YH, Sung K.
(1)Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Korea.. .
ackground: Repeated thoracic aorta repair is increasingly common. With the
increase in hybrid procedures, determination of the best treatment strategy
requires evaluation of the clinical outcomes of classic open surgery. Methods:
We retrospectively reviewed 119 patients (84 men and 35 women, aged 51.0 ± 16.7
years) with a history of open repair involving the thoracic aorta above the
diaphragm. The patients underwent an average of 1.3 ± 0.8 surgeries (range: 1-8)
on the thoracic aorta before the final operation. Clinical outcomes were
evaluated on the basis of the need for emergency surgery, indications for
surgery, pathologic causes, and other operative variables.RESULTS: Hospital
mortality was 6.7% (n = 8). Postoperative bleeding occurred in 16% (n = 19). On
multivariable analysis, emergency surgery (odds ratio [OR], 19.005; P = .003; 95%
confidence interval [CI], 2.710-133.305) and cardiopulmonary bypass (CPB) time
(OR, 1.562 per 30 minutes; P = .007; 95% CI, 1.126-2.165) were predictors of
hospital death. Emergency surgery (OR, 4.105; P = .029; 95% CI, 1.157-14.567) and
CPB time (OR, 1.189 per 30 minutes; P = .035; 95% CI, 1.012-1.396) were also
associated with postoperative bleeding, in addition to surgery for an infectious
cause (OR, 10.824; P = .010; 95% CI, 1.755-66.770). Estimated survival at 1, 5,
and 7 years was 86.6%, 80.5%, and 78.2%, respectively. Conclusion: Despite the
variety of preoperative conditions and operations performed, repeated open
surgery for thoracic aorta repair can be performed with acceptable early and late