Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Cerebral and organs protection during complex aortic surgery reconstructions

Authors: Averina T.B., Shundrov A.S., Mokrinskaya L.Yu., Guslistyy D.S., Muratov R.M., Mironenko V.A.

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2014; (): -

Quote as: Averina T.B., Shundrov A.S., Mokrinskaya L.Yu., Guslistyy D.S., Muratov R.M., Mironenko V.A. Cerebral and organs protection during complex aortic surgery reconstructions. Klinicheskaya Fiziologiya Krovoobrashcheniya. 2014; 2: 14–19.

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Abstract

Objective of the research – is to study own experience reconstructive surgeries on the aortic arch.
Material and methods. The study included 51 patients who from 2010 to 2013 was performed reconstruction ascending and arch aortic. One group of patients (44 cases) intervention was performed in the conditions of an isolated antegrade perfusion of the brain on the background of circulatory arrest for hypothermia 23,8±1,8 °C. The second group of patients (7 cases), the intervention was carried out in conditions of separate perfusion (brain and the lower body) for hypothermia 27,1±1,5 °C.
Results. There were no significant differences in in-hospital mortality, number of neurological and organ complications, the level of biochemical markers of damage to organs in the considered groups. By multiple regression analysis identified predictors of complicated postoperative course of the factors assessed intra- operative and in the early postoperative period.
Conclusion. Predictors complicated postoperative period were: for treatment outcome– resternotomy, CBP time, level of cardiotonic support at the end of the operation, reperfusion time, for neurological complications – reperfusion time and the amount of blood loss in the first postoperative day, for the multiple organ failure – resternotomy, level of blood lactate at the end of the operation and level of cardiotonic support at the end of the operation, reperfusion time. There were no significant differences in the level of mortality, the number of neurologic and renal complications, markers of internal injuries in patients with isolated antegrade perfusion of the brain on the background of circulatory arrest in con- ditions of deep hypothermia and using the separate perfusion of the brain and the lower part of the body in conditions of moderate hypothermia.

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