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Renal failure after thoracoabdominal aortic surgery

V S Kashyap1, R P Cambria, J K Davison

  • 1Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

Journal of Vascular Surgery
|January 10, 1998
PubMed
Summary

Postoperative renal failure after complex aortic surgery is linked to preoperative kidney issues and longer clamp times. Minimizing clamp duration and using hypothermic perfusion can help prevent this complication.

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Part one: the vast majority of patients with renal artery stenoses require intervention.

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery·2011

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Vascular Surgery

Background:

  • Renal failure is a significant complication following complex aortic surgery.
  • Identifying perioperative risk factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify perioperative factors contributing to postoperative renal failure after thoracoabdominal aortic surgery.
  • To assess the incidence and risk factors of acute renal failure in this patient population.

Main Methods:

  • Retrospective review of 183 patients undergoing thoracoabdominal aortic surgery with supraceliac clamping.
  • Analysis of intraoperative management, including clamp-and-sew technique and renal artery cold perfusion.
  • Evaluation of preoperative clinical features and postoperative renal function.

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Main Results:

  • Acute renal failure occurred in 11.5% of patients, with 2.7% requiring hemodialysis.
  • Preoperative renal insufficiency (creatinine > 1.5 mg/dl) and cross-clamp time > 100 minutes were significant risk factors.
  • Renal failure was associated with a significantly increased operative mortality risk (odds ratio, 9.2).

Conclusions:

  • Renal failure substantially increases early mortality risk after thoracoabdominal aortic surgery.
  • Preoperative renal insufficiency predisposes patients to postoperative renal failure.
  • Regional hypothermic perfusion and minimized clamp times are key to preventing renal failure.