Surgical treatment of aneurysms of the thoracic aorta with the aid of partial cardiopulmonary bypass: an analysis of 95 patients.
We retrospectively evaluated the surgical results in 95 patients with aneurysm of the thoracic aorta who were surgically treated using partial cardiopulmonary bypass (CPB) as an adjunctive method during the past 10 years. The cause of the aneurysm was atherosclerosis in 52% and dissection in 41%. Fifty-eight percent of the patients had an aneurysm of the entire descending thoracic aorta and 14 of these patients had a thoracoabdominal aneurysm. Emergency operation was performed in 16 patients (17%). There were 14 early deaths (14.7%) within one month after operation. Postoperative complications included renal dysfunction, partial paraplegia, and hemorrhage. Renal dysfunction occurred in 7 (7.8%) of the operative survivors; 2 of the 7 required hemodialysis. Partial paraplegia was observed in 2 patients undergoing total replacement of the thoracoabdominal aorta. Neither renal dysfunction nor paraplegia was related to the duration of aortic cross-clamping. Postoperative hemorrhage necessitating reopening of the chest occurred in 8 (8.9%) of the operative survivors. Partial CPB is useful in reducing the incidence of postoperative complications among patients undergoing aortic cross-clamping for a long period.
D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery; D001012:Aorta, Abdominal / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality / Q000601:surgery; D001807:Blood Vessel Prosthesis; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors