دورية أكاديمية
Predictors of Outcomes after Correction of Acute Type A Aortic Dissection under Moderate Hypothermic Circulatory Arrest and Antegrade Cerebral Perfusion
| العنوان: | Predictors of Outcomes after Correction of Acute Type A Aortic Dissection under Moderate Hypothermic Circulatory Arrest and Antegrade Cerebral Perfusion |
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| المؤلفون: | George Samanidis, Charalampos Katselis, Constantinos Contrafouris, Georgios Georgiopoulos, Ioannis Kriaras, Theofani Antoniou, Konstantinos Perreas |
| المصدر: | Brazilian Journal of Cardiovascular Surgery, Vol 33, Iss 2, Pp 143-150 |
| بيانات النشر: | Sociedade Brasileira de Cirurgia Cardiovascular. |
| المجموعة: | LCC:Surgery LCC:Diseases of the circulatory (Cardiovascular) system |
| مصطلحات موضوعية: | Cerebrovascular Circulation, Hypothermia, Induced/Methods, Perfusion/Methods, Aneurysm, Dissecting/Surgery, Aortic Aneurysm/Surgery, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| الوصف: | Abstract Introduction: Hypothermic circulatory arrest is widely used for correction of acute type A aortic dissection pathology. We present our experience of 45 consecutive patients operated in our unit with bilateral antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Methods: Between January 2011 and April 2015, 45 consecutive patients were admitted for acute type A aortic dissection and operated emergently under moderate hypothermic circulatory arrest and bilateral antegrade cerebral perfusion. Results: Mean age was 58±11.4 years old. Median circulatory arrest time was 41.5 (30-54) minutes while the 30-day mortality and postoperative permanent neurological deficits rates were 6.7% and 13.3%, respectively. Unadjusted analysis revealed that the factors associated with 30-day mortality were: preoperative hemodynamic instability (OR: 14.8, 95% CI: 2.41, 90.6, P=0.004); and postoperative requirement for open sternum management (OR: 5.0, 95% CI: 1.041, 24.02, P=0.044) while preoperative hemodynamic instability (OR: 8.8, 95% CI: 1.41, 54.9, P=0.02) and postoperative sepsis or multiple organ dysfunction (OR: 13.6, 95% CI: 2.1, 89.9, P=0.007) were correlated with neurological dysfunction. By multivariable logistic regression analysis, postoperative sepsis and multiple organ dysfunction independently predicted (OR: 15.9, 95% CI: 1.05, 96.4, P=0.045) the incidence of severe postoperative neurological complication. During median follow-up of 6 (2-12) months, the survival rate was 86.7%. Conclusion: Bilateral antegrade cerebral perfusion and direct carotid perfusion for cardiopulmonary bypass, in the surgical treatment for correction of acute aortic dissection type A, is a valuable technique with low 30-day mortality rate. However, postoperative severe neurological dysfunctions remain an issue that warrants further research. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1678-9741 |
| Relation: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000200143&lng=en&tlng=en; https://doaj.org/toc/1678-9741 |
| DOI: | 10.21470/1678-9741-2017-0123 |
| URL الوصول: | https://doaj.org/article/20f4f4c366a74b2c881c936acc8e624f |
| رقم الأكسشن: | edsdoj.20f4f4c366a74b2c881c936acc8e624f |
| قاعدة البيانات: | Directory of Open Access Journals |
| تدمد: | 16789741 |
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| DOI: | 10.21470/1678-9741-2017-0123 |