Cardiac papers: Surgical management of type a aortic dissection: Evaluation of predisposing factors for postoperative neurologic complication and late reoperation

Hyuk Ahn, Kwhanmien Kim, Hum Chae, Joon Ryang Rho

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The technique of cerebral protection during hypothermic circulatory arrest remains controversial. Forty-seven patients underwent operations for type A aortic dissection in the past 9 years. During hypothermic circulatory arrest, selective cerebral perfusion and retrograde cerebral perfusion was applied in 12 and seven patients, respectively. The mortality rate was 28.6% in patients without adjunctive cerebral perfusion, 25.0% in selective cerebral perfusion patients, and zero in the retrograde cerebral perfusion group (P > 0.05). However, there was no mortality by cerebral injury in cerebral perfusion groups (P = 0.03). Age (P = 0.001), hypothermic circulatory arrest time (P = 0.012). and acuity (P = 0.013) were predisposing factors for cerebral injury, but cerebral perfusion has not yet been found to be a protective factor (P = 0.56). Nine late reoperations and three deaths occurred during the follow-up period. Marfan syndrome was the only predisposing factor for late reoperation (P = 0.016). In summary, although further studies are still required, retrograde cerebral perfusion is a possible cerebral protective factor. In addition, periodic follow-up is mandatory, especially in patients with Marfan syndrome.

Original languageEnglish
Pages (from-to)104-111
Number of pages8
JournalVascular
Volume5
Issue number1
DOIs
StatePublished - 1 Jan 1997

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Reoperation
Causality
Nervous System
Dissection
Perfusion
Marfan Syndrome
Mortality
Wounds and Injuries

Keywords

  • follow-up
  • neurologic complications
  • predisposing factors
  • retrograde cerebral perfusion
  • type A aortic dissection

Cite this

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abstract = "The technique of cerebral protection during hypothermic circulatory arrest remains controversial. Forty-seven patients underwent operations for type A aortic dissection in the past 9 years. During hypothermic circulatory arrest, selective cerebral perfusion and retrograde cerebral perfusion was applied in 12 and seven patients, respectively. The mortality rate was 28.6{\%} in patients without adjunctive cerebral perfusion, 25.0{\%} in selective cerebral perfusion patients, and zero in the retrograde cerebral perfusion group (P > 0.05). However, there was no mortality by cerebral injury in cerebral perfusion groups (P = 0.03). Age (P = 0.001), hypothermic circulatory arrest time (P = 0.012). and acuity (P = 0.013) were predisposing factors for cerebral injury, but cerebral perfusion has not yet been found to be a protective factor (P = 0.56). Nine late reoperations and three deaths occurred during the follow-up period. Marfan syndrome was the only predisposing factor for late reoperation (P = 0.016). In summary, although further studies are still required, retrograde cerebral perfusion is a possible cerebral protective factor. In addition, periodic follow-up is mandatory, especially in patients with Marfan syndrome.",
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Cardiac papers : Surgical management of type a aortic dissection: Evaluation of predisposing factors for postoperative neurologic complication and late reoperation. / Ahn, Hyuk; Kim, Kwhanmien; Chae, Hum; Rho, Joon Ryang.

In: Vascular, Vol. 5, No. 1, 01.01.1997, p. 104-111.

Research output: Contribution to journalArticle

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