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Predictor of neurologic dysfunction after elective thoracic aorta repair using selective cerebral perfusion
Kunihide Nakamura1, Toshio Onitsuka, Mitsuhiro Yano
1The Department of Surgery 2, Miyazaki Medical College, University of Miyazaki, Miyazaki, Japan. shiori@med.miyazaki-u.ac.jp
Scandinavian Cardiovascular Journal : SCJ
|August 16, 2005
Summary
Cerebrovascular disease (CVD) and low superficial temporal artery (STA) pressure during selective cerebral perfusion (SCP) are key risk factors for postoperative neurological dysfunction after thoracic aortic surgery. Awareness aids in preventing complications.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Vascular Disease
Background:
- Selective cerebral perfusion (SCP) is used during thoracic aortic operations.
- Postoperative neurological dysfunction (PND) is a potential complication.
Purpose of the Study:
- To identify factors influencing PND after SCP during thoracic aortic surgery.
- To evaluate the impact of cerebrovascular disease (CVD) and intraoperative parameters on neurological outcomes.
Main Methods:
- A cohort of 60 patients undergoing thoracic aortic operations with SCP between 1995 and 2004 were assessed.
- Preoperative CVD status and perioperative factors were analyzed using univariate and multivariate methods.
- Superficial temporal artery (STA) pressure during SCP was a key variable examined.
Main Results:
- The hospital mortality rate was 0%.
- Cerebrovascular disease (CVD) was present in 26.7% of patients.
- Permanent neurological dysfunction (PND) occurred in 5.0% and transient neurological dysfunction (TND) in 3.3%.
- Multivariate analysis identified CVD (p = 0.038) and low STA pressure during SCP (p = 0.032) as independent risk factors for PND.
Conclusions:
- Cerebrovascular disease (CVD) is an independent risk factor for PND following thoracic aortic surgery with SCP.
- Superficial temporal artery (STA) pressure during SCP is also a significant predictor of PND.