Comparative evaluation of visceral and renal protection methods during thoracoabdominal aortic repair (Experience of Russian Surgery Research Center named after B.V. Petrovsky)

The objective: to compare the effectiveness of visceral and renal protection methods during thoracoabdominal aortic (TAA) repair: left atrial-femoral bypass (LAFB) and cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) of these organs.Subjects: 81 patients who underwent TAA re...

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Main Authors: E. Yu. Chepurnyak, Yu. V. Belov, E. R. Charchyan, A. A. Eremenko, L. S. Lokshin, B. A. Аkselrod, O. V. Dymova, K. A. Zinoviev, A. V. Panov
Format: Article
Language:Russian
Published: New Terra Publishing House 2021-05-01
Series:Вестник анестезиологии и реаниматологии
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Online Access:https://www.vair-journal.com/jour/article/view/514
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Summary:The objective: to compare the effectiveness of visceral and renal protection methods during thoracoabdominal aortic (TAA) repair: left atrial-femoral bypass (LAFB) and cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) of these organs.Subjects: 81 patients who underwent TAA repair were enrolled in retrospective analysis: LAFB was used in 29 patients (Group 1), CPB and SP ‒ in 52 patients (Group 2).Results. In Group 2, there were lower intraoperative blood loss volume (1,500 ml vs 4,200 ml, p < 0.001), significantly lower levels of direct bilirubin, blood creatinine, blood alpha-amylase in postoperative period, significantly shorter duration of hospital stay, ICU stay and duration of mechanical ventilation. Also in this group, there were lower incidence of multiple organ dysfunction (11.5% vs 37.9%, p = 0.005), stroke (0 vs 10.3%, p = 0.043), lower need for requirement (3.8% vs 20.7%, p = 0.022) and mortality (3.8% vs 27.6%, p = 0.003).Conclusion: During TAA repair, CPB in conjunction with selective visceral and renal perfusion is more beneficial for organ protection as compared with LAFB.
ISSN:2078-5658
2541-8653