Surgery of the thoracic aorta in Denmark 1997-2003]

A retrospective review was undertaken to evaluate the results after surgery of the thoracic aorta in Denmark 1997-2003 and to evaluate if the organisation of surgery was in accordance with recommendations from The National Health Service. All operations were performed at one of the five cardiothoracic surgical departments in Denmark according to the recommendations from the National Health Service. However, this review showed that 49 different surgeons performed 542 operations corresponding to 1.7 operation per surgeon per year.Discharge letters and operative notes on patients operated for aortic aneurysm or aortic dissection were collected from The National Patient Registry. The study comprises 542 patients at a mean age of 59 +/- 12 years of age of whom 366 (68%) were operated on acutely. 369 patients were operated for aortic dissection and 173 were operated for aortic aneurysm. The number of operations increased from 59 in 1997 to 100 in 2003.30 day mortality was 18% for aneurysms and 30% for dissections. The mean postoperative length of stay was 35 +/- 12 days. When comparing the operating hospitals, there was no difference in mortality or in postoperative length of stay. 345 patients (64%) developed one or more postoperative complications. Severe neurologic complications developed in 20% of the patients operated for aortic dissection and in 10% operated for aortic aneurysm. Reoperation for bleeding occurred in 19% of the patients operated for aortic dissection and in 10% operated for aortic aneurysm.This study has shown that mortality and complication rate are higher in Denmark compared with corresponding studies abroad and it should be possible to improve the results in the future.