Effects of deep hypothermic circulatory arrest on outcome after resection of ascending aortic aneurysm.
BACKGROUND
Aneurysm of the ascending aorta is a common finding especially in patients with aortic valve diseases. The aim of this study was to analyze early and midterm outcome in patients operated on for aneurysm of the ascending aorta with or without the use of deep hypothermic circulatory arrest (DHCA).


METHODS
Between January 1996 and December 2000, 133 of 410 patients with thoracic aortic pathology were operated on for an aortic aneurysm limited mainly to the ascending aorta. Early and midterm outcomes were assessed and quality of life (QOL) evaluated using the Short-Form 36 Health Survey Questionnaire (SF-36).


RESULTS
Sixty patients (group 1) were operated on with DHCA and 73 patients (group 2) without DHCA. In-hospital mortality was identical in both groups (9.6% versus 6.7%; p = not significant) whereas postoperative transient neurologic events were significantly more frequent in group 1 (6.7% versus 0%; p < 0.05). Midterm clinical outcome was not different between groups but QOL showed significant impairment in daily functional physical and emotional activity in group 1 patients compared with group 2 and an age-matched standard population.


CONCLUSIONS
The risk of transient neurologic complications is significantly increased with the use of DHCA and QOL is impaired without benefits in the long-term outcome especially among older patients.
Immer
Franz F
FF
Department of Cardiovascular Surgery, University Hospital, Berne, Switzerland. franzimmer@yahoo.de
Barmettler
Hanna
H
Berdat
Pascal A
PA
Immer-Bansi
Alexsandra S
AS
Englberger
Lars
L
Krähenbühl
Eva S
ES
Carrel
Thierry P
TP
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome