A Single Institution’s Experience with Complex Thoracic Aortic Surgery in Resource Restricted Environment

We evaluated the early outcomes of surgical repair of complex thoracic aortic surgery(aortic dissection,aneurysm & trauma) retrospectively in a single institution between 1994 and 2014.Early clinical follow up was performed and complications classified according to the International Aortic Arch Surgery Study.Three hundred and twenty patients where evaluated with a mean age of 45,68 years.Emergency surgery comprised of 37.5%(n=120) of patients.The overall mortality was 17.5%(n=56) and mean ICU stay 4.5 days.The intraoperative mortality was 6.8%(n=22).Eleven patients where HIV positive(3.4%) and the neurological complications 2.18%(n=7).We considered predictors of postoperative complications and identified old age,longer bypass and aortic cross clamp times and previous cardiac surgery to be independent risk factors for mortality. Despite advances in perioperative management resource limitations and the high burden of disease,emergency surgery including trauma contributed to the poor outcome of these patients.