| Home | Bolesti | Dijagnostika | Lijekovi | Radovi | Novosti | Forum | Linkovi |
luk
Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

CIRCULATORY ARREST IN SURGERY OF THE PROXIMAL AORTA: A PERSONAL EXPERIENCE
B. Đukanović
Dedinje Cardiovascular Institute, Belgrade, Yugoslavia

Methods: During the last five years, a total of 92 patients with diseases of the proximal aorta were operated in our institution using deep hypothermic circulatory arrest (DHCA). The group was consisted of 77 men and 15 women, aged 28 to 72 years. Reasons for surgery included DeBakey type I and II acute aortic dissection in 37 patients, chronic dissecting aneurysm in 19 patients, degenerative aneurysm of the proximal aorta in 35 patients, and couldn't infection in 1 patient. Of these patients, 42 were operated on emergency basis. In all patients, surgical technique included resection of the dilated and/or dissected aorta, which was replaced with tubular grafts. Additionally, there were a total of 87 concomitant procedures (coronary artery bypass grafting in 26 patients, aortic valve replacement sec. Bental in 56 patients, aortic valve sparing procedure in 2 patients, mitral valve replacement in 2 patients, and femoro-femoral cross-over in 1 patient. REDO procedures were performed in 14 (15,2%) patients. Retrograde perfusion of the brain through superior vena cava was used in 62 patients. Circulatory arrest occurred at the temperatures from 15 to 19 degrees centigrade. Results: Postoperatively, 11 patients died. Death occurred because of myocardial infraction in 2 patients, respiratory insufficiency and multiple organ failure in 4 patients, gastrointestinal bleeding in 2 patients, and heart failure, renal insufficiency and stroke in 1 patient each. Major postoperative complications were observed in 32 (35%) patients. Neurological deficit was noticed in only 1 patient who died as a consequence of stroke. Conclusions: The use of DHCA allows excellent conditions for complex procedures on proximal aorta, including REDO procedures, with acceptable early results. Retrograde perfusion of the brain ameliorates brain protection and contributes to faster neurological recovery following surgery.

 

 

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
HealthBosnia.com - ima autorska prava na ovu stranu. Svako objavljivanje
teksta ili dijelova ovog teksta je moguće samo uz saglasnost HealthBosnia.com
© 1999-2001, by HealthBosnia.com, e-mail medmaster@koming.com. ALL RIGHTS RESERVED.