The ideal aortic center is a maximum care center which treats all pathologies from the aortic root downwards, including the side branches and target organs. Furthermore, it offers the best quality of all treatment modalities round the clock. Should aortic surgery only be performed at ideal aortic centers?meta-analyses, which investigated the volume-outcome relationship for abdominal aortic aneurysm (aaa) surgery identified a hospital and/or surgeon low annual operation volume as being a significant mortality predictor. Data from these studies suggested that aaa surgery should be performed only at high-volume centers but there is no evidence to centralize patients with infrarenal, juxtarenal and suprarenal aaa in maximum care aortic centers as defined above. However, absolutely safe aaa surgery requires a competent and experienced team, a minimal annual case volume and an adequate infrastructure. These conditions are more or less applicable to thoracic endovascular aortic repair (tevar). In contrast thoracic aortic aneurysm (taa) open repair and all thoracic abdominal aortic aneurysms (taaa) should be treated in specialized aortic centers because taa(a) surgery requires high expertise and vast experience as well as extensive technical equipment to provide extracorporeal circulation and neuromonitoring.
- Aortic surgery
- Aortic aneurysm
- Endovascular aortic repair
- Thoracic endovascular aortic repair