title: Renal and abdominal visceral complications after open aortic surgery requiring supra-renal aortic cross clamping.
abstract: OBJECTIVE
  The aim of this study was to assess renal or abdominal visceral complications after open aortic surgery (OAS) requiring supra-renal aortic cross clamping (SRACC).
  
  
  METHODS
  We retrospectively reviewed the medical records of 66 patients who underwent SRACC. Among them, 17 followed supra-celiac aortic cross clamping (SCACC) procedure, 42 supra-renal, and 7 inter-renal aorta. Postoperative renal, hepatic or pancreatic complications were investigated by reviewing levels of serum creatinine and hepatic and pancreatic enzymes. Preoperative clinical and operative variables were analyzed to determine risk factors for postoperative renal insufficiency (PORI).
  
  
  RESULTS
  Indications for SRACC were 25 juxta-renal aortic occlusion and 41 aortic aneurysms (24 juxta-renal, 12 supra-renal and 5 type IV thoraco-abdominal). The mean duration of renal ischemic time (RIT) was 30.1 ± 22.2 minutes (range, 3 to 120 minutes). PORI developed in 21% of patients, including four patients requiring hemodialysis (HD). However, chronic HD was required for only one patient (1.5%) who had preoperative renal insufficiency. RIT ≥ 25 minutes and SCACC were significant risk factors for PORI development by univariate analysis, but not by multivariate analysis. Serum pancreatic and hepatic enzyme was elevated in 41% and 53% of the 17 patients who underwent SCACC, respectively.
  
  
  CONCLUSIONS
  Though postoperative renal or abdominal visceral complications developed often after SRACC, we found that most of those complications resolved spontaneously unless there was preexisting renal disease or the aortic clamping time was exceptionally long.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Shin-Seok
authors.initials: SS
authors.lastname: Yang
authors.forename: Keun-Myoung
authors.initials: KM
authors.lastname: Park
authors.forename: Young-Nam
authors.initials: YN
authors.lastname: Roh
authors.forename: Yang Jin
authors.initials: YJ
authors.lastname: Park
authors.forename: Dong-Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Young-Wook
authors.initials: YW
authors.lastname: Kim