Outcomes of circulatory arrest procedures for the treatment of thoracic aortic disease at a veterans facility.

Background: The outcomes of thoracic aortic surgery involving hypothermic circulatory arrest at a US Department of Veterans Affairs medical center were evaluated.

Methods: Using the Veterans Affairs Continuous Improvement in Cardiac Surgery Program, all thoracic aortic operations performed with hypothermic circulatory arrest between December 1999 and December 2009 were identified (n = 24). Operative mortality and morbidity were evaluated, and survival was assessed by using the Kaplan-Meier method.

Results: Aortic dissection was the underlying disease in 10 patients (42%). Full or hemiarch aortic repair was performed in 16 patients (67%); of these operations, 3 (13%) involved elephant trunk repair. There was 1 operative death (4%). Four patients (17%) had strokes (all but 1 fully recovered), and 1 (4%) had renal failure. The survival rate was 90% at 1 year and 67% at 3 years.

Conclusions: Despite the magnitude and risk of thoracic aortic surgery involving hypothermic circulatory arrest, good outcomes can be achieved when such surgery is performed at an experienced Veterans Affairs center.