Document Detail

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.
MedLine Citation:
PMID:  19411260     Owner:  NLM     Status:  MEDLINE    
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.
Nawid Khaladj; Issam Ismail; Malakh Shrestha; Sven Peterss; Maximilian Pichlmaier; Klaus Kallenbach; Axel Haverich; Christian Hagl
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-01
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  246-50     Citation Subset:  IM    
Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany.
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MeSH Terms
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
Heart Valve Diseases / complications,  mortality,  surgery*
Heart Valve Prosthesis Implantation / adverse effects*,  mortality
Middle Aged
Neurologic Examination
Patient Selection
Quality of Life
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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