Asian Cardiovasc Thorac Ann 2004;12:69-74
© 2004 Asia Publishing EXchange Ltd
Extensive Thoracoabdominal Aortic Aneurysm Repair Using Deep Hypothermic Bypass and Circulatory Arrest
Hiroyuki Nishi, MD,
Satoru Miyamoto, MD,
Hirokazu Minamimura, MD,
Takumi Ishikawa, MD,
Yasuyuki Kato, MD,
Hideki Arimoto, MD,
Kensuke Ohue, MD,
Yoshihiro Shimizu, MD
Department of Cardiovascular Surgery, Osaka General City Hospital, Osaka, Japan
For reprint information contact: Hiroyuki Nishi, MD Tel: 81 6 6929 1221 Fax: 81 6 6929 1091 Email: nishi24{at}jc4.so-net.ne.jp Department of Cardiovascular Surgery, Osaka City General Hospital 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka, 534-0021, Japan.
We sought to evaluate the safety and usefulness of deep hypothermic cardiopulmonary bypass with intervals of circulatory arrest for extensive thoracoabdominal aortic aneurysms. Between March 1994 and December 2002, 17 patients with Crawford type I and II were reviewed retrospectively. The patients were divided into two groups: group H (hypothermic circulatory arrest, n = 8) and group N (normothermic cardiopulmonary bypass, n = 9). In group H, in-hospital mortality was 12.5%, and that in group N was 11.1%. Operation times were similar between the two groups though the cardiopulmonary bypass time was significantly shorter in group N than in group H (p < 0.05). Postoperative paraplegia occurred in 1 patient of group N. Postoperative renal dysfunction occurred in none of group H except in 1 preoperative dialysis case, whilst it occurred in 6 patients of group N. Postoperative creatinine levels were significantly higher in group N than in group H. Three cases in group H required tracheostomy. Our experience with hypothermic cardiopulmonary bypass and circulatory arrest for diffuse type thoracoabdominal aortic aneurysm confirms the safety and efficacy of this technique. Although respiratory complications remain a problem, the technique is considered to be effective for renal protection.
Copyright © 2004 by the Asia Publishing EXchange Ltd.
