OBJECTIVE: The purpose of this study was to describe clinical outcome after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA), to determine mortality and length of stay, neurologic outcome, cardiorespiratory outcome, and hemostatic and renal outcome after DHCA. DESIGN: Retrospective and observational. SETTING: Cardiothoracic operating rooms and intensive care unit (ICU). PARTICIPANTS: All adults requiring thoracic aortic repair with DHCA. INTERVENTIONS: None. The study was observational. MAIN RESULTS: The cohort size was 110. All patients received an antifibrinolytic. The mortality rate was 8.2%. The mean length of stay was 6.8 days (ICU) and 14.0 days (hospital). The incidence of stroke was 8.1% and postoperative delirium was 10.9%. The rate of postoperative atrial fibrillation was 43.6%; 19.1% required postoperative mechanical ventilation longer than 72 hours. Chest tube drainage was 931 mL for the first 24 hours. Postoperative dialysis was required in 1.8% of patients. Renal dysfunction occurred in 40% to 50% of patients, depending on the definition. CONCLUSIONS: The protocol for DHCA at the authors' institution is associated with superior or equivalent perioperative outcomes to those reported in the literature. This study identified the need for further quantification of the clinical outcomes after DHCA in order to prioritize outcome-based hypothesis-driven prospective intervention in DHCA.
OBJECTIVE: The purpose of this study was to describe clinical outcome after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA), to determine mortality and length of stay, neurologic outcome, cardiorespiratory outcome, and hemostatic and renal outcome after DHCA. DESIGN: Retrospective and observational. SETTING: Cardiothoracic operating rooms and intensive care unit (ICU). PARTICIPANTS: All adults requiring thoracic aortic repair with DHCA. INTERVENTIONS: None. The study was observational. MAIN RESULTS: The cohort size was 110. All patients received an antifibrinolytic. The mortality rate was 8.2%. The mean length of stay was 6.8 days (ICU) and 14.0 days (hospital). The incidence of stroke was 8.1% and postoperative delirium was 10.9%. The rate of postoperative atrial fibrillation was 43.6%; 19.1% required postoperative mechanical ventilation longer than 72 hours. Chest tube drainage was 931 mL for the first 24 hours. Postoperative dialysis was required in 1.8% of patients. Renal dysfunction occurred in 40% to 50% of patients, depending on the definition. CONCLUSIONS: The protocol for DHCA at the authors' institution is associated with superior or equivalent perioperative outcomes to those reported in the literature. This study identified the need for further quantification of the clinical outcomes after DHCA in order to prioritize outcome-based hypothesis-driven prospective intervention in DHCA.
Authors: George J Arnaoutakis; Timothy J George; Kevin K Wang; Mary Ann Wilson; Jeremiah G Allen; Chase W Robinson; Kara A Haggerty; Eric S Weiss; Mary E Blue; Charles C Talbot; Juan C Troncoso; Michael V Johnston; William A Baumgartner Journal: J Thorac Cardiovasc Surg Date: 2011-10 Impact factor: 5.209
Authors: Mary E Blue; Mary Ann Wilson; Claude A Beaty; Timothy J George; George J Arnaoutakis; Kara A Haggerty; Melissa Jones; Jeffrey Brawn; Shaliza Manmohan; Mary S Lange; Michael V Johnston; William A Baumgartner; Juan C Troncoso Journal: J Neuropathol Exp Neurol Date: 2014-12 Impact factor: 3.685
Authors: Jeremiah G Allen; Eric S Weiss; Mary Ann Wilson; George J Arnaoutakis; Mary E Blue; C Conover Talbot; Chunfa Jie; Mary S Lange; Juan C Troncoso; Michael V Johnston; William A Baumgartner Journal: Ann Thorac Surg Date: 2010-06 Impact factor: 4.330
Authors: Matthew A Schechter; Asad A Shah; Brian R Englum; Judson B Williams; Asvin M Ganapathi; John D Davies; Ian J Welsby; G Chad Hughes Journal: J Crit Care Date: 2015-11-06 Impact factor: 3.425
Authors: John G T Augoustides; Arnar Geirsson; Wilson Y Szeto; Elizabeth K Walsh; Brittany Cornelius; Alberto Pochettino; Joseph E Bavaria Journal: Nat Clin Pract Cardiovasc Med Date: 2008-12-09