Risk factors for severe complications after total aortic arch replacement / 中华麻醉学杂志

ABSTRACT

Objective To determine the risk factors for severe complications after total aortie areh replacement.Methods Patients with acute type A aortic dissection of both sexes,scheduled for elective total aortic areh replacement,were selected.According to whether or not postoperative severe complications occurred during hospitalization,the patients were divided into either postoperative severe complications group or non-postoperative severe complication group.Factors including age,gender,body mass index,preoperative complications (Marfan syndrome,hypertension and diabetes mellitus),preoperative left ventricular ejection fraetion,levels of serum N-terminal pro-brain natriuretic peptide,hemoglobin and serum alanine aminotransferase,aspartate aminotransferase and creatinine,international normalized ratio,operation time,cardiopulmonary bypass time,selective antegrade cerebral perfusion time,regional cerebral oxygen saturation (rSO2),etc.were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistie regression analysis to stratify postoperative severe complications-related risk factors for this type of patients.Results A total of 98 patients were enrolled in this study.Of the 98 patients,28 patients developed posloperative severe complications,and the incidence was 29c％.The results of logistic regression analysis showed that age＞60 yr,△rSO2-min＜80％ throughout the surgery and △rSO2-min＜80％ during hemostasis were independent risk factors for severe complications after total aortie arch replacement.Conclusion Age ＞60 yr,△rSO2-min＜80％ throughout the surgery and △rSO2-min＜80％ during hemostasis are independent risk factors for severe complications after total aortic arch replacement.