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Partial cardiopulmonary bypass in thoracoabdominal aorta repair: a safe alternative in a low-volume center
Nicolas Nunez-Ordonez1,2, Julian Senosiain3, Juan Andres Sarmiento4
1Facultad de Medicina, Universidad del Rosario, Bogotá, Colombia. nicolas.nunez@javeriana.edu.co.
Objective:
To describe postoperative outcomes with the use of partial CPB for thoracoabdominal aortic repair.
Methods:
We included all the patients who underwent programmed thoracoabdominal aortic procedures in which partial cardiopulmonary bypass was used at a single institution. Long term follow-up was collected by review of health records, national databases and via telephone.
Results:
The study involved 134 patients. Hypertension was present in 78% of patients. The primary surgical indication was an aortic aneurysm (67%), though aortic dissection was also common (33%). Extensive repairs and postoperative complications, such as acute kidney injury and RRT requirement, were significantly associated with increased mortality (p < 0.05). Patients with aortic dissection had worse outcomes, including higher rates of hypertension, stroke, and other complications (p < 0.05). Early mortality was notably higher in extent and II and IV repairs.
Conclusions:
Thoracoabdominal aorta repair can be safely performed with the use of partial CPB in a low-volume setting when undertaken by a dedicated, experienced Aorta team.
