SURGICAL OUTCOME OF AORTIC-ARCH ANEURYSMS USING SELECTIVE CEREBRAL PERFUSION
SURGICAL OUTCOME OF AORTIC-ARCH ANEURYSMS USING SELECTIVE CEREBRAL PERFUSION
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DOI：
10.1016/0003-4975(94)90201-1
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发表时间：
1994-04-01
影响因子：
4.6
通讯作者：
KOMATSU, S
中科院分区：
文献类型：
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作者：
KAZUI, T;KIMURA, N;KOMATSU, S
对1986年1月至1992年8月底行主动脉弓动脉瘤手术的80例患者的手术结果进行多因素分析，以确定高手术风险的预测因素。所有手术均采用体外循环技术，血液停搏心肌保护，选择性脑灌注预防主动脉弓修复过程中的脑缺血。总体早期（30天）死亡率为16.3%。1例（1.3%）患者术后发生严重卒中。Kaplan-Meier法测定5年生存率为73%±5%。多因素分析显示术前是否存在严重的心肺功能障碍和是否需要再手术是重要的独立预测因素。在63例（79%）无这些风险的患者中，只有3例（4.8%）死亡。本研究的结果表明，目前，所有接受主动脉弓动脉瘤手术的患者的早期死亡率相对较低，除非他们在术前处于危急状态或除非他们正在进行再次手术。
The surgical results observed in 80 patients with aneurysms of the aortic arch who underwent an operation between January 1986 and the end of August 1992 were analyzed by multivariate analysis to identify predictors of high operative risk. All operations were performed using a cardiopulmonary bypass technique, blood cardioplegia for myocardial protection, and selective cerebral perfusion to prevent cerebral ischemia during aortic arch repair. The overall early (30-day) mortality rate was 16.3%. A severe stroke occurred postoperatively in 1 patient (1.3%). The 5-year survival rate was 73% +/- 5%, as determined by the Kaplan-Meier method. Multivariate analysis revealed that the presence of critical cardiopulmonary dysfunction preoperatively and the need for reoperation were significant independent predictors. Of the 63 (79%) patients who were free of these risks, only 3 (4.8%) died. The findings from the present study indicate that, currently, early mortality is relatively low for all patients who undergo operations for aneurysm of the aortic arch, unless they are in a critical condition preoperatively or unless they are undergoing a reoperation.