Estrera et al identified risk factors affecting survival following ascending and transverse aortic arch repair. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Texas at Houston and the Memorial Hermann Heart and Vascular Institute.


Outcome: 30-day mortality following surgery


Risk factors associated with a poor outcome on multivariate analysis:

(1) poor renal function as measured by the glomerular filtration rate (GFR)

(2) emergency surgery

(3) prolonged pump time during surgery

(4) poor retrograde cerebral perfusion



30-Day Mortality

> 100 mL per min


56 to 99 mL per min

9 to 10%

< 55 mL per min



Additional factors identified on univariate analysis:

(1) severe coronary artery disease

(2) acute dissection

(3) prolonged circulatory arrest

(4) advanced age


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