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The Journal of Cardiovascular Surgery 2002 April;43(2):167-73

language: English

Correlation between age and vital organ function following deep hypothermic circulatory arrest

Ueno T., Itoh T., Rikitake K., Ohtubo S., Hamada M., Okazaki Y.

From the Depart­ment of Tho­racic and Car­di­o­vas­cular Sur­gery Saga Med­ical ­School, ­Saga, ­Japan


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Back­ground. We inves­ti­gated the cor­re­la­tion ­bet-ween per­i­op­er­a­tive var­i­ables ­such as ­patients’ age and ­vital ­organ func­tion ­after oper­a­tion on tho­racic ­aorta ­using ­deep hypo­thermic cir­cu­la­tory ­arrest (DHCA).
­Methods. ­Ninety-­five ­patients who under­went replace­ment of tho­racic ­aorta ­under ­DHCA for ­acute or ­chronic ­aortic dis­sec­tion and ­aortic aneu­rysm, and sur­vived ­more ­than 10 ­days ­were ­divided ­into ­group I (age ­less ­than 60, n=17), ­group II (­between 60 and 69, n=39), and ­group III (­over 70, n=39). Con­com­i­tant pro­ce­dures ­such as ­aortic ­root replace­ment and cor­o­nary ­artery ­bypass ­grafting ­were per­formed in 9, 4, and 1 ­patients in ­group I, II, and III, respec­tively. Post­op­er­a­tive pul­mo­nary, ­renal, and ­hepatic func­tion ­within 10 ­days ­were com­pared. Cor­re­la­tion ­between ­other per­i­op­er­a­tive var­i­ables and ­organ func­tion was ­also inves­ti­gated ­among all 95 ­patients.
­Results. Post­op­er­a­tive pul­mo­nary, ­renal, and ­hepatic func­tion in ­group III was not sig­nif­i­cantly infe­rior to ­those in ­groups I and II. The oper­a­tion ­time, and ­amount of red ­blood ­cells and ­fresh ­frozen ­plasma ­used ­during oper­a­tion, ­were sig­nif­i­cantly ­greater in ­group I, ­which ­showed an inti­mate cor­re­la­tion to sig­nif­i­cant ele­va­tion of ­hepatic ­enzymes.
Con­clu­sions. ­Although ­lower func­tional ­reserve of ­vital ­organs in the eld­erly ­patients was pre­dicted, ­they ­showed an accept­able func­tional ­recovery ­after oper­a­tion ­with ­DHCA. ­Other per­i­op­er­a­tive var­i­ables ­such as oper­a­tion ­time and ­blood trans­fu­sion ­showed a neg­a­tive ­impact on post­op­er­a­tive ­hepatic func­tion.

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