| Aortic root surgery in combination with hypothermic circulatory arrest: preserve or replace the aortic valve in the context of postoperative neurological outcome? A case match comparison. | |
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MedLine Citation:
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PMID: 19411260 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The objective of this study was to compare the results of elective composite (C) vs. David (D) operations in patients requiring additional aortic arch surgery using hypothermic circulatory arrest (HCA) and selective antegrade cerebral perfusion (SACP), with the focus on postoperative neurological outcome and quality of life (SF-36). Between November 1999 and March 2006, 333 patients underwent aortic root surgery and ascending aortic replacement with HCA and SACP at our institution. Out of these patients, 46 were matched with respect to age, gender, HCA-time and year of surgery. Two patients, one in each group, died during hospital stay (4%), with no late deaths. Follow-up was completed in 95% [64 (6-90) months]. Cardiopulmonary bypass (CPB) time (141 min vs. 168 min, P=0.007) and aortic cross-clamp time (99 min vs. 123 min, P=0.004) were significantly longer in the David-group. The incidence of temporary neurological dysfunction (TND 7%: D n=1, C n=2) was not different between groups, no permanent dysfunction could be detected. Follow-up SF-36 scores were comparable. The combination of aortic arch surgery with more time consuming valve sparing aortic root surgery does not increase the risk for adverse outcome applying comparable periods of HCA and SACP. |
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Authors:
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Nawid Khaladj; Issam Ismail; Malakh Shrestha; Sven Peterss; Maximilian Pichlmaier; Klaus Kallenbach; Axel Haverich; Christian Hagl |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-05-01 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 9 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-24 Completed Date: 2009-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 246-50 Citation Subset: IM |
Affiliation:
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Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany. Khaladj.Nawid@mh-hannover.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Diseases / complications, mortality, surgery* Aortic Valve / surgery* Blood Vessel Prosthesis Implantation / adverse effects*, mortality Cardiopulmonary Bypass Case-Control Studies Cerebrovascular Circulation Cerebrovascular Disorders / etiology*, mortality, physiopathology Circulatory Arrest, Deep Hypothermia Induced / adverse effects*, mortality Constriction Female Heart Valve Diseases / complications, mortality, surgery* Heart Valve Prosthesis Implantation / adverse effects*, mortality Humans Male Middle Aged Neurologic Examination Patient Selection Perfusion Quality of Life Questionnaires Risk Assessment Risk Factors Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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