Risk analysis for aortic surgery using hypothermic circulatory arrest withretrograde cerebral perfusion

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.