Perfusion with low systemic heparinization during resection of descending thoracic aortic aneurysms

Détails

ID Serval
serval:BIB_8798527A9BA8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Perfusion with low systemic heparinization during resection of descending thoracic aortic aneurysms
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
von Segesser  L. K., Weiss  B. M., Garcia  E., Turina  M.
ISSN
1010-7940
Statut éditorial
Publié
Date de publication
1992
Peer-reviewed
Oui
Volume
6
Numéro
5
Pages
246-9; discussion 250
Notes
Journal Article
Research Support, Non-U.S. Gov't
Résumé
Two series of 20 consecutive patients with aneurysms of the descending thoracic aorta (TAA) and thoraco-abdominal aorta (TAAA) underwent multisegmental aortic repair using either simple normothermic crossclamping and rapid reanastomosis (historic) or partial cardiopulmonary bypass (CPB) with heparin coated perfusion equipment and low systemic heparinization (actual). Chronic lesions were present in 14/20 patients (70%) for simple versus 13/20 (65%) for CPB (NS). Acute lesions (symptomatic less than 24 h) were present in 6/20 patients (30%) for simple versus 7/20 (35%) for CPB (NS). Dissecting lesions were observed in 4/20 patients (20%) for simple versus 8/20 (40%) for CPB (NS). Aneurysmal lesions were found in 16/20 patients (80%) for simple versus 12/20 (60%) for CPB (NS). Mean number of aortic segments (n = 8) resected was 3.2 +/- 1.1 for simple versus 4.0 +/- 1.2 for CPB (P less than 0.01). Replacement of the transdiaphragmatic aorta was performed in 10/20 patients (50%) for simple and 13/20 patients (65%) for CPB (NS). A heparin loading dose of 5000 IU for simple versus 100 IU/kg bodyweight for CPB was used. In the latter group, the activated clotting time was kept above 180 s during a mean perfusion time of 46 +/- 28 min at a mean pump flow of 2.2 +/- 0.7 l/min. Thirty-day survival for all (transdiaphragmatic) was 12/20 (5/10) patients for simple versus 20/20 (13/13) for CPB (P less than 0.002, P less than 0.01). One-year survival (all) was 11/20 patients (55%) for simple versus 19/20 (95%) for CPB (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Mots-clé
Aged Aneurysm, Dissecting/blood/mortality/surgery Aorta, Thoracic/*surgery Aortic Aneurysm/blood/mortality/*surgery Aortic Rupture/blood/mortality/surgery Blood Vessel Prosthesis Cardiopulmonary Bypass/*instrumentation Dose-Response Relationship, Drug Female Heparin/*administration & dosage Humans Male Middle Aged Postoperative Complications/mortality Survival Rate Whole Blood Coagulation Time
Pubmed
Web of science
Création de la notice
14/02/2008 15:17
Dernière modification de la notice
03/03/2018 19:02
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