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The Annals of Thoracic Surgery, Vol 57, 904-911, Copyright © 1994 by The Society of Thoracic Surgeons
T Kazui, N Kimura, O Yamada and S Komatsu
The surgical results observed in 80 patients with aneurysms of the aortic
arch who underwent an operation between January 1986 and the end of August
1992 were analyzed by multivariate analysis to identify predictors of high
operative risk. All operations were performed using a cardiopulmonary
bypass technique, blood cardioplegia for myocardial protection, and
selective cerebral perfusion to prevent cerebral ischemia during aortic
arch repair. The overall early (30-day) mortality rate was 16.3%. A severe
stroke occurred postoperatively in 1 patient (1.3%). The 5-year survival
rate was 73% +/- 5%, as determined by the Kaplan-Meier method. Multivariate
analysis revealed that the presence of critical cardiopulmonary dysfunction
preoperatively and the need for reoperation were significant independent
predictors. Of the 63 (79%) patients who were free of these risks, only 3
(4.8%) died. The findings from the present study indicate that, currently,
early mortality is relatively low for all patients who undergo operations
for aneurysm of the aortic arch, unless they are in a critical condition
preoperatively or unless they are undergoing a reoperation.
ARTICLES
Surgical outcome of aortic arch aneurysms using selective cerebral perfusion
Second Department of Surgery, Sapporo Medical University School of Medicine, Japan.
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