Analysis of in-hospital death of aortic arch replacement under deep hypothermic circulatory arrest and antegrade cerebral perfusion / 中华胸心血管外科杂志

ABSTRACT

Objective To analyze risk factors for in-hospital death of aortic arch replacement under deep hypothermic circulatory arrest and antegrade cerebral perfusion.Methods Between January 2005 and December 2011,626 cases aortic arch replacement under deep hypothermic circulatory arrest and antegrade cerebral perfusion were retrospectively analyzed.The cause of death were recorded and univariate and multivariate analysis (multiple logistic regression) were used to identify the risk factors.Results In-hospital death occurred in 29 cases (4.6％) and in them 2 cases because of aortic dissection rupture,5 cases severe neurological injury,11 cases low cardiac output syndrome and 11 cases multiple organ failure.Multiple logistic regression showed that stroke history(OR =6.703,95％ CI1.664-27.000,P ＝ 0.007),preoperative hemodynamic instability(OR =6.441,95％ CI1.213-34.212,P =0.029),eardiopulmonary bypass time(OR =1.008,95％ CI1.002-1.014,P =0.007) and CABG(OP =4.525,95％ CI1.542-13.279,P =0.006) were independent risk factors for in-hospital death.Conclusion Stroke history,preoperative hemodvnamic instability and coronary involvement indicate high risk in operation,and mortality maybe can be reduced by controlling CPB time.