Early Results of Ascending Aorta and Aortic Arch Surgery in Albania

Background: Treatment of aneurysms of the ascending aorta, arch aorta, or both are surgically challenging and has traditionally carried a high hospital mortality rate. The use of refined operative techniques has resulted in reduced hospital mortality rates. Patients and Methods: We conducted a prospective analysis of consecutive patients who underwent 74 surgical procedures between January 2011 and January 2014, for graft replacement of the ascending aorta or transverse aortic arch. There were 58 men (78.4%) and 16 women (21.6%). The mean age was 55.3±9.8 years (range 30 ? 74 years). The etiology was medial degeneration in 44 patients (59.5%), bicuspid aortic pathology in 28 patients (37.8%) and aortic dissection in 2 patients (2.7%). Fifteen patients (20.3%) were operated on an emergency basis for acute aortic dissection. Results: The ascending aorta was replaced in all 69 patients (93,2%) and plicated in five patients (6.8%). Ascending aorta and aortic arch were replaced in 9 patients (12.1%). 17 patients had only ascended aortic procedure, 35 patients had separate aortic valve and ascending aorta replacement (47.3%), and 18 patients (24.3%) received a valved conduit (Modified Bentall procedure). Concomitant bypass grafting was performed in nine patients. Mean cross-clamp and bypass times were 115.38±41.19 min and 143.26±55.79 min respectively. The Early hospital mortality rate was 3.38% (2 out of 59 patients) in the elective surgery group and 26.67% in the emergency group (4 out of 15). Conclusions: Surgery of the ascending aorta and aortic arch can be performed with low morbidity and mortality rates at our clinic in Albania.