Analysis of neurological complication after type DeBakey Ⅰ aortic dissection / 中国医师进修杂志

ABSTRACT

ObjectiveTo evaluate the risk factors and of neurological complications after type DeBakey Ⅰ aortic dissection. MethodsSeventy patients underwent operations of the aortic dissection with deep hypothermic circulatory arrest (DHCA) in combination with antegrade selective cerebral perfusion (ASCP). Perioperative factors were evaluated by means of univariate and multivariate logistic analysis to identify relative risk factors of neurological complications. ResultsOne case was exduded. The extracorporeal circulation time was (158.39 ±47.16) min,the aortic crossclamp time was (99.12 ±46.27) min,the brain stop circulation time was (29.83 ± 6.85 ) min. Neurological complications occurred in 19 patients (27.5％),including 10 patients with temporary cerebral dysfunction, 3 patients with permanent cerebral dysfunction, 2patients with paraplegia,4 patients with hoarseness. Renal and hepatic dysfunction, hypertension disease,aortic crossclamp time ＞ 120 min,circulatory arrest time ＞40 min, blood transfusion volume ＞4000 ml,arterial blood pressure instability ＞ 80 mm Hg ( 1 mm Hg = 0.133 kPa) and postoperative low cardiac output were the risk factors for cerebral complication (P ＜ 0.05 or ＜ 0.01 ). ConclusionsNo single risk factor explains the onset of neurological complications. Cerebral perfusion duration within the limits of safe time and the methods of cerebral perfusion does not influence the neurological complications. Protection of all the endorgans would be helpful to the cerebral protection.