Contemporary results of open thoracic and thoracoabdominal aortic surgery in a single United Kingdom center

ObjectiveTo report our outcomes and identify predictors of mortality after open descending thoracic aneurysm (DTA) thoracoabdominal aortic (TAAA) repair in a specialist center.MethodsThis retrospective observational cohort study included consecutive patients who underwent surgery at institution between October 1998 December 2019. The main outcome measures were major morbidities. A multivariate analysis was used to mortality.ResultsThere 430 DTA (n = 157) TAA 273) repair; 151 nonelectively. Forty-eight (11%) died within 30 days surgery. 30-day lower elective (3.1% 9.9% TAAA repair), whereas nonelective had 17.9%. Fourteen additional hospital days, one 13 (10 elective), all but extent II. In-hospital for the whole improved over time, as activity volume increased, except undergoing II repair. Predictors in-hospital age ?70 years (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.79-6.32; P < .001), (OR, 4.39; CI, 2.34-8.21; 2.72; 1.44, 5.12; .002), out-of-hours 8.17; 2.16-30.95; left ventricular ejection fraction <30% 9.86; 1.91-50.86; .006), degenerative 2.20; 1.12-4.31; .02). incidence stroke paraplegia 7.1% 0% 3.3% Hemodialysis necessary 5.1% cases 22.7% repair.ConclusionsOpen carries significant risk life, which is related age, replacement, timing surgery, function. Morbidity considerable. Understanding these risks fundamental patient selection consent process potential candidates particularly elderly.