Gm. Deeb et al., Risk analysis for aortic surgery using hypothermic circulatory arrest withretrograde cerebral perfusion, ANN THORAC, 67(6), 1999, pp. 1883-1886
Citations number
7
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. Retrospective analysis of 144 patients undergoing aortic arch r
econstruction using hypothermic circulatory arrest (HCA) with retrograde ce
rebral perfusion (RCP) for cerebral protection was performed.
Methods. The diagnosis, procedure, and anatomic site of the arch anastomosi
s were analyzed to see if they were independent predictors of mortality or
morbidity. In addition age, gender, HCA-RCP times, preoperative malperfusio
n (both treated and untreated), surgical status, and redo surgery status we
re also examined to determine their influence on the incidence of death and
complications. Both multivariate and univariate analysis were performed us
ing linear regression and cross-tabulation with either chi(2) or Fisher's e
xact test where appropriate.
Results. Preoperative surgical status (emergent) and the presence of untrea
ted preoperative malperfusion were the only variables that were significant
independent predictors for mortality (p < 0.05). No variable was significa
nt for the prediction of stroke or other complications. The severity of sur
gery had no bearing on the patient outcome.
Conclusions. Complex aortic surgery using HCA-RCP can be performed with acc
eptable risk to the patients. (C) 1999 by The Society of Thoracic Surgeons.