Abstract
Thoracic and thoracoabdominal aortic aneurysm repair are frequently associated with ischemic paraplegia, renal failure and death. In order to decrease the incidence of ischemic events and allow for a longer aortic cross clamp time, we combined our previous technique of segmental sequential repair, left heart bypass and cerebral spinal fluid drainage in conjunction with moderate hypothermia (30°C). Twenty-seven adult patients underwent elective thoracic (n=6) or thoracoabdominal (n=21) aortic aneurysm repair from January 1992 to September 1993 utilizing this hypothermic technique. A heat exchanger was integrated in the centrifugal left heart bypass circuit to achieve moderate hypothermia (30°C) and regain normothermia (37°C) prior to partial bypass termination. Cannulation for left heart bypass was aorta- femoral artery (n=10) or left atrium-femoral artery (n=17). The surgical technique of segmental sequential repair helps to minimize visceral, kidney and spinal cord ischemia. Among these 27 patients, one developed delayed paraplegia on postoperative day 3 and three suffered postoperative death. The average aortic cross clamp time was 76 ± 7 minutes. Previous studies have demonstrated a significant increase of ischemic morbidity (11-25%) when cross clamp times exceeded 30 minutes. We conclude that the combination of left heart bypass, moderate hypothermia and cerebral spinal fluid drainage allow for a longer duration of aortic cross clamp time and a relatively low incidence of ischemic complications.
Original language | English (US) |
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Pages (from-to) | 172-177 |
Number of pages | 6 |
Journal | Journal of Extra-Corporeal Technology |
Volume | 26 |
Issue number | 4 |
State | Published - Dec 1 1994 |
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Health Professions (miscellaneous)
- Cardiology and Cardiovascular Medicine