Affiliation:
1. Russian Surgery Research Center Named after B.V. Petrovsky
2. Russian Surgery Research Center Named after B.V. Petrovsky; I. M. Sechenov First Moscow State Medical University (Sechenov University)
Abstract
The objective: to compare the effectiveness of visceral and renal protection methods during thoracoabdominal aortic (TAA) repair: left atrial-femoral bypass (LAFB) and cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) of these organs.Subjects: 81 patients who underwent TAA repair were enrolled in retrospective analysis: LAFB was used in 29 patients (Group 1), CPB and SP ‒ in 52 patients (Group 2).Results. In Group 2, there were lower intraoperative blood loss volume (1,500 ml vs 4,200 ml, p < 0.001), significantly lower levels of direct bilirubin, blood creatinine, blood alpha-amylase in postoperative period, significantly shorter duration of hospital stay, ICU stay and duration of mechanical ventilation. Also in this group, there were lower incidence of multiple organ dysfunction (11.5% vs 37.9%, p = 0.005), stroke (0 vs 10.3%, p = 0.043), lower need for requirement (3.8% vs 20.7%, p = 0.022) and mortality (3.8% vs 27.6%, p = 0.003).Conclusion: During TAA repair, CPB in conjunction with selective visceral and renal perfusion is more beneficial for organ protection as compared with LAFB.
Subject
General Materials Science
Reference26 articles.
1. Belov Yu.V., Vinokurov I.А. Acute renal failure after operations on thoracoabdominal aorta under organs protection with solution custodiol. Kardiologiya i Serdechno-Sosudistaya Khirurgiya, 2014, vol. 7, no. 4, pp. 24-28. (In Russ.)
2. Belov Yu.V., Khamitov F.F. Surgical protection of the spinal cord and visceral organs during thoracoabdominal aortic replacement. Grudnaya i Serdechno-Sosudistaya Khirurgiya, 2000, vol. 4, pp. 54-57. (In Russ.)
3. Belov Yu.V., Charchyan E.R., Stepanenko А.B. et al. Surgical treatment of patients with thoracoabdominal aortic aneurysms. Khirurgiya. Journal im. N. I. Pirogova, 2015, vol. 12, pp. 33-38. (In Russ.)
4. Komarov R.N., Vinokurov I.А., Karavaykin P.А. et al. A staged method of hybrid prosthetics of the thoracoabdominal aorta. Khirurgiya. Journal im. N. I. Pirogova, 2018, no. 2, pp. 21-27. (In Russ.)
5. Mamaev А.N., Kudlay D.А. Statisticheskiye metody v meditsine. [Statistical methods in medicine]. Moscow, Prakticheskaya Meditsina Publ., 2021, 136 p. ISBN 978-5-98811-635-6.