Journal of the Formosan Medical Association
Volume 107, Issue 5 , Pages 412-418, May 2008

Aortic Surgery Requiring Hypothermic Circulatory Arrest in Octogenarians

  • Ying-Cheng Chen
    • ,
  • Ron-Bin Hsu

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Ron-Bin Hsu, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received 26 September 2007; received in revised form 3 January 2008; accepted 15 January 2008.

Article Outline

Background

Recent improvements in the outcomes of cardiovascular operation in octogenarians have resulted in an increase in the number of referrals of elderly patients for aortic surgery requiring hypothermic circulatory arrest.

Methods

This was a retrospective chart review.

Results

Between 2000 and 2007, 12 octogenarians with aortic aneurysms underwent surgery requiring hypothermic circulatory arrest. There were seven men with a median age of 83 years (range, 80-87 years). Diagnoses of aortic disease included acute type A aortic dissection in seven patients and degenerative thoracic aneurysm in five. Operation was performed through median sternotomy in eight patients and posterolateral thoracotomy in four. The median duration of hypothermic circulatory arrest was 50 minutes (range, 15-84 minutes). Method of brain protection during hypothermia was selective antegrade cerebral perfusion in five patients, retrograde cerebral perfusion in two, and arrest alone in five. The hospital mortality rate was 8%. Major postoperative complications occurred in six (50%) patients, with transient neurologic dysfunction in two patients and no stroke.

Conclusion

Although postoperative complications were common, the clinical outcome of aortic surgery requiring hypothermic circulatory arrest was acceptable.

Key Words:  aortic surgery , hypothermic circulatory arrest , octogenarian

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PII: S0929-6646(08)60107-2

doi:10.1016/S0929-6646(08)60107-2

Journal of the Formosan Medical Association
Volume 107, Issue 5 , Pages 412-418, May 2008

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