Clinical and Post-Surgical Features and Outcomes in Post-Surgical Patients with Aortic arch Interruption at a Specialty Hospital in Bogotá Between 2006 and 2019. Retrospective Multivariable Analysis

Abstract

Introduction. Interruption of the aortic arch due to absence of tissue between the ascending and descending portions of the aorta is a pathology of low incidence, yet it has a mortality rate of nearly 90% within the first year of life. Surgical intervention is aimed at re-establishing continuity of the vessel, as well as correcting associated lesions through closure of IVC or performing a pulmonary artery cerclage correction. The mortality is 18% to 42%. The survival rate is close to 73% at one month, 65% at one year and 63% at 3 years after surgery. Materials and Methods. Review of Cardiovascular Surgery database between 2006 and 2019, identifying patients who underwent surgery due to aortic arch interruption. Results. In the last 4 years, an institutional technique was introduced, using pericardium tissue for reconstruction and partial junction of the descending aorta with the arch through advancement of the arterial cannulae towards the brachiocephalic trunk and has been positively associated to brain protection. Since, results have improved: lower tissue traction, greater amplitude of the neoarch and better neurological outcomes have been achieved. The objective of this paper is to identify the most important factors that ultimately determine prognosis and survival of patients with these pathologies, as well as to describe results of the implemented technique. Discussion. Aortic arch surgery is considered to be highly complex. Results yielded in this research showed a high mortality within the first years, which decreased into a similar rate to that of medical literature. The main factors associated with complications identified were a late diagnosis and malnutrition. In addition, morbidity and mortality rates were similar to those reported worldwide.