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ORIGINAL ARTICLES  CARDIAC SECTION 

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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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