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Author Notes:

Corresponding author. Division of Cardiothoracic Surgery, Emory Clinic Suite A2223, 1365 Clifton Road, Atlanta, GA 30322, USA. Tel: +1-404-7783484; fax: +1-404-7784103; e-mail: epchen@emory.edu (E.P. Chen).


Research Funding:

The funding for this manuscript was internal funds from the Division of Cardiothoracic Surgery Clinical Research Unit.


  • Aortic surgery
  • Hypothermic circulatory arrest
  • Redo surgery

Outcomes following redo sternotomy for aortic surgery


Journal Title:

Interactive Cardiovascular and Thoracic Surgery


Volume 15, Number 1


, Pages 63-68

Type of Work:

Article | Post-print: After Peer Review


Proximal thoracic aortic reconstruction performed with or without hypothermic circulatory arrest (HCA) is an effective surgical strategy for aortic pathology. In this study, the clinical outcomes of patients undergoing reoperative proximal thoracic aortic surgery were evaluated. A retrospective review was performed for reoperative proximal aortic surgery from 2004 to date. Patient data were abstracted from the society of thoracic surgeons (STS) institutional database and patient charts. Univariate analysis was conducted on the HCA group in order to determine the impact of variables on in-hospital mortality. Kaplan–Meier survival estimates were calculated for long-term survival analysis. One hundred and twenty-two patients were included in the analysis. Twenty-seven (22.1%) were female, and the mean age was 53.8 years. Seventy-seven (63.1%) patients had an aortic root replacement, and 93 (76.2%) patients underwent aortic arch replacement. Circulatory arrest was performed in 92 (75.4%) patients. Operative mortality occurred in 14 patients (11.5%). Complications included re-exploration for haemorrhage (nine patients, 7.4%), stroke (four, 3.3%), renal failure (13, 10.7%) and major adverse events (18, 14.8%). Univariate and multivariate analyses of HCA patients showed cardiopulmonary bypass (CPB) time, preoperative renal failure and prior coronary revascularization as independent predictors of mortality. Reoperative proximal aortic surgery can be performed with acceptable morbidity and mortality. These data also suggest that HCA represents a safe operative strategy for this patient population.

Copyright information:

© The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved

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