• Ken Yamanaka, Tatsuhiko Komiya, Hiroshi Tsuneyoshi, and Takeshi Shimamoto.
• Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
• Ann Thorac Cardiovasc Surg. 2016 Aug 23; 22 (4): 251-7.

ObjectiveTotal aortic arch replacement is a highly invasive procedure. Here, we have investigated patient outcomes following total aortic arch replacement with or without coronary artery bypass grafting.MethodsOne hundred and eighty-one patients underwent total aortic arch replacement without coronary artery bypass grafting, and 65 underwent with coronary artery bypass grafting. We compared preoperative, operative, and postoperative factors and analyzed survival outcomes. We used univariate and multivariate analyses to determine factors associated with long-term mortality.ResultsCardiopulmonary bypass and surgical times were significantly longer in the concomitant total aortic arch replacement with coronary artery bypass grafting group. Hospital mortality was 3.3% in the total aortic arch replacement group and 7.7% in the concomitant total aortic arch replacement with coronary artery bypass grafting group. Perioperative myocardial infarction was not seen in either group. There were no significant differences in mortality between the groups. Multivariate analysis revealed preoperative age, ischemic heart disease, and estimated glemerular filtration rate (eGFR) as risk factors affecting long-term mortality, whereas concomitant total aortic arch replacement with coronary artery bypass grafting was not a risk factor.ConclusionAlthough patients' backgrounds should be considered, total aortic arch replacement can be concomitantly performed with coronary artery bypass grafting surgery without additional mortality risk.

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