[Comparative study of hypothermic XXXX and normothermic distal perfusion for @entity2334 repair].

@entity1 @entity8 @entity5721 @entity548 @entity954 @entity1614 @entity532 @entity177 @entity51 @entity2334 @entity1576 @entity881 @entity1167 @entity1580 @entity2332
BACKGROUND: Hypothermic bypass with @entity1167 for @entity2334 ( @entity2334 ) repair is employed for its protective effect on spinal cord function and because it avoids clamping the diseased aorta. However, @entity881 caused by @entity5721 as well as @entity548 tendencies due to deep @entity2332 have been described. In this paper we compared the efficacies of the hypothermic and normothermic operations. METHODS: Between February 1996 and June 2000, 28 @entity1 underwent thoracoabdominal aortic repair. Twenty-three @entity1 were @entity1 , 5 were @entity1 , and the median age was 55.3 (range 23 to 75 years). Fourteen @entity1 had @entity1580 , and 7 had @entity1614 . Fourteen @entity1 required reconstruction of visceral arteries. Twelve @entity1 underwent @entity2334 repair under deep hypothermic @entity1167 (H group), and 15 under normothermic distal perfusion (N group), while 1 @entity1 underwent a simple clamp procedure. Perioperative data and early outcomes were compared between groups. RESULTS: The overall 30-day mortality rate was 0%, but 3 @entity1 (25.0%) in II group, and 1 @entity1 (6.3%) in N group died during hospital stay. Operation time and bypass time were longer in H group than N group (operative time 793 min vs. 481 min (p < 0.05): cardiopulmonary bypass (CPB) time 255 min vs. 102 min (p < 0.05). Also, more @entity954 was found in H group than in N group (3,506 ml vs. 1,220 ml). @entity51 did not occur in either group. @entity1576 occurred in 3 @entity1 (25.0%) in H group and one (6.3%) in N group. @entity177 occurred in 3 (25.0%) in H group, and none in N group. CONCLUSION: Early and mid-term outcome of @entity2334 repair was almost satisfactory and without @entity532 . The deep hypothermic operation is more likely to induce postoperative respiratory and @entity8 than the normothermic operation. @entity2334 repair using deep hypothermic @entity1167 should be limited to @entity1 with @entity2334 involving the distal arch or a severely calcified aortic wall.
