Outcome of Aortic Surgery in the setting of a tertiary care cardiac institute in Pakistan

Aim: to review the outcome of aortic surgical procedures performed by one surgical team between november 2011 to january 2015. methods: the total number of patients was 31. three patients had acute aortic dissection and were operated as emergency/salvage procedure. the remaining patients had elective surgery. their median age was years. the surgical procedures included bentall operation (n=11),bentall with aortic arch replacement (n=2),bentall with mitral valve repair (n=1),redo aortic valve replacement with reconstruction of aortic root (n=2),resection of abdominal aortic aneurysm (n=4),resection of descending thoracic aneurysm (n=1),repair of co-arctation of aorta (n=8),repair of aneurysm at the origin of superior mesenteric artery and thrombo-endarterectomy of aortic bifurcation (n=1). results: the median bypass time for aortic root replacement was 175 min and the average cross-clamp time was 122 min. the median clamp time for thoracic and abdominal aortic procedure was 16 minutes. the postoperative ventilation time was 5 hours,the icu stay was less than 24 hours,and the duration of hospital stay was 7-days. the median chest drainage was 390 ml while median number of blood transfusions included 1 unit of packed rbcs and 1.5 units of fresh frozen plasma. there were two deaths and both patients suffered from acute aortic dissection. conclusion: the data confirms highly rewarding outcome in aortic surgery in pakistan. paradoxically the referral for such operations is very limited which reflects general misunderstandings about the outcome in the minds of referring physicians. moreover poor logistic and financial support might be another reason for patients not reaching the cardiac institutes.