Stage I Procedure
We identified 152 patients who underwent an ET procedure, with a mean age of 64± 14 years and a mean maximal aortic diameter of 5.3±0.6. Among the total population, 50.6% were females. The large majority of patients (n=125, 82%) carried a diagnosis of hypertension, and 15.8% had baseline neurologic abnormalities, including prior strokes (n=15). Patient characteristics are listed in Table 1.
Stage I procedure was carried out in all patients either electively (n=119, 78%), urgently (n=29, 19%) or on an emergent basis (n=4, 3%). Indications for aortic repair were either aortic aneurysm (n=97, 64%), aortic dissection (n=44, 29%) or other acute aortic syndromes (PAU or rupture, n=11, 7%). DHCA was conducted in all patients, with a mean duration of 41±16 minutes, and average cardiopulmonary bypass time of 161±41 minutes (Table 2).
Operative mortality (30 day or in-house) was 3.3% (5/152). Of these, two patients had fatal strokes, 2 patients died from multi-organ failure, and 1 patient expired due descending aortic rupture prior to planned Stage II repair. All 147 surviving patients were triaged to either Stage II repair or long-term monitoring. The median interval between surgery date and death was 12 days.
Complications: After the Stage I procedure, post-operative stroke (confirmed by computed tomography or magnetic resonance imaging) occurred in 7 patients (4.6%). Of these, 2 patients expired within 30 days. Re-exploration for bleeding was required in 14 patients (9%) and 4 patients (2.6%) required renal replacement therapy (RRT).