CONTEMPORARY OUTCOMES OF AORTIC ARCH REPAIR WITH HYPOTHERMIC CIRCULATORY ARREST: THE IMPACT OF URGENCY STATUS EVIDENCE FROM THE CANADIAN THORACIC AORTIC COLLABORATIVE
CCC ePoster Library. Ghoneim A. 10/26/19; 280529; 294
Dr. Aly Ghoneim
Dr. Aly Ghoneim
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Rate & Comment (0)
BACKGROUND: The aim of this study was to analyze the contemporary outcomes of patients undergoing aortic arch surgery with hypothermic circulatory arrest (HCA), according to their urgency status.

METHODS AND RESULTS: A total of 2624 patients (62 years (0.3), 70% male, 63% elective vs 37 % non-elective) who underwent aortic arch repair with HCA among 12 Canadian centres between 2002 and 2018 (Figure.1). Elective patients were compared to non-elective (urgent, emergent & salvage surgery) for early in-hospital outcomes ( < 30 days). Overall in-hospital mortality occurred in 218 (8.3%) patients, with higher mortality in non-elective vs elective patients (15.7% vs 2.4%, p < 0.001). Adverse neurological events occurred in 307 patients (11.7%) [stroke 207 (7.9%), spinal cord injury 34 (1.3%) and transient ischemic attack 66 (2.9%)] with more neurological events in non-elective vs elective patients (15.6% vs 8.1%, p < 0.001). The risk of stroke was significantly higher in the non-elective group [n=114 (11.6%)] vs the elective group [n=91 (5.6%)]; p < 0.001). Antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion were employed in 1805 (70.1%) and 275 (10.7%) patients respectively, however, 373 (14.2%) patients underwent circulatory arrest with hypothermia alone.

CONCLUSION: This contemporary series demonstrated the safety of cerebral circulatory arrest with good outcomes when conducted in cardiac surgery centres with aortic expertise. Nonetheless, mortality and morbidity remain higher in non-elective patients, hence, further research is needed to improve outcomes in non-elective aortic arch surgery
BACKGROUND: The aim of this study was to analyze the contemporary outcomes of patients undergoing aortic arch surgery with hypothermic circulatory arrest (HCA), according to their urgency status.

METHODS AND RESULTS: A total of 2624 patients (62 years (0.3), 70% male, 63% elective vs 37 % non-elective) who underwent aortic arch repair with HCA among 12 Canadian centres between 2002 and 2018 (Figure.1). Elective patients were compared to non-elective (urgent, emergent & salvage surgery) for early in-hospital outcomes ( < 30 days). Overall in-hospital mortality occurred in 218 (8.3%) patients, with higher mortality in non-elective vs elective patients (15.7% vs 2.4%, p < 0.001). Adverse neurological events occurred in 307 patients (11.7%) [stroke 207 (7.9%), spinal cord injury 34 (1.3%) and transient ischemic attack 66 (2.9%)] with more neurological events in non-elective vs elective patients (15.6% vs 8.1%, p < 0.001). The risk of stroke was significantly higher in the non-elective group [n=114 (11.6%)] vs the elective group [n=91 (5.6%)]; p < 0.001). Antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion were employed in 1805 (70.1%) and 275 (10.7%) patients respectively, however, 373 (14.2%) patients underwent circulatory arrest with hypothermia alone.

CONCLUSION: This contemporary series demonstrated the safety of cerebral circulatory arrest with good outcomes when conducted in cardiac surgery centres with aortic expertise. Nonetheless, mortality and morbidity remain higher in non-elective patients, hence, further research is needed to improve outcomes in non-elective aortic arch surgery
    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.


Save Settings