초록접수 현황
| 19F-146 | 구연 발표 |
Implications of Lower Body Perfusion for Surgeries of Acute Aortic Dissection.
Ho Hyun Ko, Gu Byung Mo, Weon Yong Lee
Department of Thoracic and Cardiovascular Surgery, Sacred Heart Hospital, Hanllym University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : Surgeries of acute aortic dissection (AAD) require circulatory arrest or lower body ischemia and cause serious morbidities and mortalities. We evaluated early surgical outcomes of ADD in terms of reducing lower body ischemia.
Methods : Between September 2017 and August 2019, 22 patients (age, 64.9±13.2 years; 45.5% male) underwent aortic reconstruction for AAD. Twenty patients (90.3%) were diagnosed as type A dissection and 3 patients (13.6%) presented neurologic deficits preoperatively. Pruitt aortic occlusion catheter connected to additional arterial circuit was directly inserted to descending thoracic aorta and continuous lower body perfusion was achieved with the rate of 1 L/min. The primary endpoints were early mortalities and morbidities. The secondary endpoints were overall survival rates.
Results : Extent of aorta replacement was determined by intraoperative exploring of intimal tear sites (hemiarch; 9;40.1%, partial arch 2;9.1%, total arch replacement 11;50%). Two concomitant Bentall procedures and one Aortic valvuloplasty were performed. Mean aortic cross clamping and cardiopulmonary bypass time was 160.3±36.5 minutes and 278.4±63.6 minutes. There were two early mortalities (9.1%) followed by pneumonia and sepsis. Postoperative complications were mediastinal bleeding (2;9.1%), stroke (3;13.6%), pneumonia (5;22.7%), vocal cord palsy (2;9.1%), and pericardial effusion (3;13.6%). Acute kidney injury, mesenteric and spinal cord ischemia, and acute hepatic impairment did not occur. One-year survival by Kaplan-Meier analysis was 90.5±0.06% (median follow up; 9.1 months, IQR;5.0 to 19.9 months).
Conclusion : Decreasing lower body ischemic time during surgeries for AAD showed favorable outcomes by reducing end-organ damage and facilitating early extubation and ambulation.
Methods : Between September 2017 and August 2019, 22 patients (age, 64.9±13.2 years; 45.5% male) underwent aortic reconstruction for AAD. Twenty patients (90.3%) were diagnosed as type A dissection and 3 patients (13.6%) presented neurologic deficits preoperatively. Pruitt aortic occlusion catheter connected to additional arterial circuit was directly inserted to descending thoracic aorta and continuous lower body perfusion was achieved with the rate of 1 L/min. The primary endpoints were early mortalities and morbidities. The secondary endpoints were overall survival rates.
Results : Extent of aorta replacement was determined by intraoperative exploring of intimal tear sites (hemiarch; 9;40.1%, partial arch 2;9.1%, total arch replacement 11;50%). Two concomitant Bentall procedures and one Aortic valvuloplasty were performed. Mean aortic cross clamping and cardiopulmonary bypass time was 160.3±36.5 minutes and 278.4±63.6 minutes. There were two early mortalities (9.1%) followed by pneumonia and sepsis. Postoperative complications were mediastinal bleeding (2;9.1%), stroke (3;13.6%), pneumonia (5;22.7%), vocal cord palsy (2;9.1%), and pericardial effusion (3;13.6%). Acute kidney injury, mesenteric and spinal cord ischemia, and acute hepatic impairment did not occur. One-year survival by Kaplan-Meier analysis was 90.5±0.06% (median follow up; 9.1 months, IQR;5.0 to 19.9 months).
Conclusion : Decreasing lower body ischemic time during surgeries for AAD showed favorable outcomes by reducing end-organ damage and facilitating early extubation and ambulation.
책임저자: Weon Yong Lee
Department of Thoracic and Cardiovascular Surgery, Sacred Heart Hospital, Hanllym University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Ho Hyun Ko, E-mail : xeros1518@gmail.com