초록접수 현황
| 20F-193 | 구연 발표 |
Unilateral or bilateral antegrade cerebral perfusion during circulatory arrest for arch surgery
Jung-Hwan Kim, Seung Hyun Lee, Sak Lee, Young-Nam Youn, Kyung-Jong Yoo, Hyun-Chel Joo
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Purpose : The purpose of the study was to investigate the clinical outcomes associated with the application of unilateral or bilateral antegrade cerebral perfusion (ACP) during circulatory arrest for arch surgery.
Methods : Between January 2004 and December 2019, 684 patients underwent open aortic arch repair with circulatory arrest using ACP and were divided into two groups according to the manner of ACP: the unilateral ACP (n=314, 45.9%) or the bilateral ACP (n=370, 54.1%) groups. Primary endpoint was permanent neurologic deficit (PND) (newly developed stroke documented by imaging study or irreversible hypoxic brain injury). Secondary endpoints were transient neurologic deficit (TND) (transient ischemic attack, seizure, delayed awakening, cognitive disorder, or delirium which were fully recovered before hospital discharge) and in-hospital mortality.
Results : The patients’ baseline characteristics were comparable between the groups, but there was more acute type A aortic dissection in unilateral ACP group (39.8% vs. 32.2%, p=0.04). The PND (5.1% in unilateral vs. 5.7% in bilateral, p=0.74) and in-hospital mortality (6.4% in unilateral vs. 4.9% in bilateral, p=0.39) were not significantly different between the groups. The unilateral ACP was not associated with PND (OR=0.89 [0.46-1.74], p=0.74), TND (OR=0.85 [0.46-1.57], p=0.61) and in-hospital mortality (OR=1.33 [0.69-2.56], p=0.39). Subgroup analysis showed that the unilateral ACP was not significantly associated with PND in acute type A aortic dissection (OR=0.82 [0.29-2.35], p=0.72) and in chronic aneurysm (OR=0.92 [0.34-2.19], p=0.84).
Conclusion : In this study, unilateral ACP and bilateral ACP were associated with comparable neurologic outcomes and mortality during circulatory arrest for arch surgery.
Methods : Between January 2004 and December 2019, 684 patients underwent open aortic arch repair with circulatory arrest using ACP and were divided into two groups according to the manner of ACP: the unilateral ACP (n=314, 45.9%) or the bilateral ACP (n=370, 54.1%) groups. Primary endpoint was permanent neurologic deficit (PND) (newly developed stroke documented by imaging study or irreversible hypoxic brain injury). Secondary endpoints were transient neurologic deficit (TND) (transient ischemic attack, seizure, delayed awakening, cognitive disorder, or delirium which were fully recovered before hospital discharge) and in-hospital mortality.
Results : The patients’ baseline characteristics were comparable between the groups, but there was more acute type A aortic dissection in unilateral ACP group (39.8% vs. 32.2%, p=0.04). The PND (5.1% in unilateral vs. 5.7% in bilateral, p=0.74) and in-hospital mortality (6.4% in unilateral vs. 4.9% in bilateral, p=0.39) were not significantly different between the groups. The unilateral ACP was not associated with PND (OR=0.89 [0.46-1.74], p=0.74), TND (OR=0.85 [0.46-1.57], p=0.61) and in-hospital mortality (OR=1.33 [0.69-2.56], p=0.39). Subgroup analysis showed that the unilateral ACP was not significantly associated with PND in acute type A aortic dissection (OR=0.82 [0.29-2.35], p=0.72) and in chronic aneurysm (OR=0.92 [0.34-2.19], p=0.84).
Conclusion : In this study, unilateral ACP and bilateral ACP were associated with comparable neurologic outcomes and mortality during circulatory arrest for arch surgery.
책임저자: Hyun-Chel Joo
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Jung-Hwan Kim, E-mail : jhkim0907@yuhs.ac