Is Hypothermic Circulatory arrest a risk factor for Patients with aortic Pathology?
The paper describes the experience of the Ukrainian Children’s Cardiac Center (UCCC) of the Ministry of Health of Ukraine in the field of surgical treatment of patients with aortic pathology using hypothermic circulatory arrest (HCA).
The objective of this work was to analyze the outcomes and complications after surgical interventions on the ascending aorta and aortic arch using HCA.
Materials and methods. 122 patients with ascending aortic aneurysm and aortic arch aneurysm underwent surgical interventions at the UCCC in the period from 2012 to 2018. The patients were divided into 2 groups: study group including 33 patients who were exposed to HCA and comparison group including 89 patients without HCA.
Results. The incidence of postoperative complications in patients who were exposed to HCA technique was greater than that in patients who underwent surgical interventions without HCA. Stroke was detected only in 3% of patients exposed to HCA. The incidence of postoperative bleeding was significantly higher in patients who underwent HCA than in those without HCA (12% vs 2.2%, respectively). The incidence of wound infections was significantly higher in patients who underwent HCA than in those without using HCA (6% vs 0%, respectively).
Conclusion. HCA is associated with higher early postoperative mortality (9% vs 0%) and higher risk of postoperative complications, e.g. stroke, postoperative bleeding, wound infections, compared to surgical interventions without HCA. Patients who underwent HCA required transfusion of a greater number of blood components and longer duration of mechanical ventilation, longer stay in an intensive care unit and subsequent hospital stay compared to those without using HCA.
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