27 December 2002
Experience with cerebral perfusion in total aortic arch replacement.
Anil Z. Apaydin, Fatih Islamoglu, Hikmet Iyem, Hakan Posacioglu, Tahir Yagdi, Suat BüketMed Sci Monit 2002; 8(12): CR801-804 :: ID: 4808
Abstract
BACKGROUND: The interruption of cerebral circulation is a major problem in the surgical repair of the aortic arch. This study was undertaken to identify the perioperative risk factors for mortality and neurological morbidity, and the outcome after total aortic arch replacement. MATERIAL/METHODS: Between June 1995 and March 2002, 23 patients (13 males) underwent total aortic arch replacement. The mean age was 61.7I9.4 years (range 35-77). All patients underwent total arch replacement with a period of hypothermic circulatory arrest (HCA). Selective cerebral perfusion was utilized as an adjunct to HCA (retrograde in 19 patients and antegrade in 4 patients). The elephant trunk technique was used in 18 patients, while proximal and middle portion of the descending aorta was also replaced in 5 patients. The patient information in our database was retrospectively reviewed. The risk factors affecting mortality and morbidity were analyzed by univariate analysis. RESULTS: The in-hospital mortality rate was 17.4%. None of the survivors developed major stroke. Temporary neurological dysfunction (TND) was seen in 5 patients. Univariate analysis revealed that excessive blood transfusion was the only factor correlated with hospital death among 18 perioperative variables (p<0.006). HCA lasting > 55 minutes and a history of hypertension were associated with the development of TND (p<0.032 and p<0.02, respectively). CONCLUSIONS: Total arch replacement can be performed with acceptable mortality and neurological morbidity. Midterm survival is excellent in hospital survivors. The duration of HCA is not associated with in-hospital mortality when selective cerebral perfusion (either antegrade or retrograde) is used as an adjunct.
Keywords: Heart Arrest, Induced - adverse effects, Heart Arrest, Induced - mortality
Editorial
01 July 2022 : Editorial
Editorial: World Health Organization (WHO) Variants of Concern Lineages Under Monitoring (VOC-LUM) in Response to the Global Spread of Lineages and Sublineages of Omicron, or B.1.1.529, SARS-CoV-2DOI: 10.12659/MSM.937676
Med Sci Monit 2022; 28:e937676
SARS-CoV-2/COVID-19
27 June 2022 : Clinical Research
Shoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who...Med Sci Monit In Press; DOI: 10.12659/MSM.937430
04 June 2022 : Clinical Research
Screening for SARS-CoV-2 Infection in Students at the Medical University of Warsaw, Poland Between November...Med Sci Monit 2022; 28:e936962
30 May 2022 : Clinical Research
Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...Med Sci Monit 2022; 28:e936069
27 May 2022 : Clinical Research
Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)Med Sci Monit 2022; 28:e936547
In Press
01 Jul 2022 : Clinical Research
Does Early-Period Patient Dissatisfaction Turn Into Satisfaction Over Time After Total Knee Replacement?Med Sci Monit In Press; DOI: 10.12659/MSM.936792
30 Jun 2022 : Laboratory Research
Bcl-2 19-kDa Interacting Protein 3 (BNIP3)-Mediated Mitophagy Attenuates Intermittent Hypoxia-Induced Human...Med Sci Monit In Press; DOI: 10.12659/MSM.936760
30 Jun 2022 : Clinical Research
Antioxidant System and Ions Concentrations After Femoral Neck and Resurfacing Hip ArthroplastyMed Sci Monit In Press; DOI: 10.12659/MSM.936335
28 Jun 2022 : Meta-Analysis
Urodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-AnalysisMed Sci Monit In Press; DOI: 10.12659/MSM.937166
Most Viewed Current Articles
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788
01 Nov 2020 : Review article
Long-Term Respiratory and Neurological Sequelae of COVID-19DOI :10.12659/MSM.928996
Med Sci Monit 2020; 26:e928996