Hypothermic cardiopulmonary bypass and XXXX in the management of extensive thoracic and thoracoabdominal aortic aneurysms.

@entity1 @entity1667 @entity64 @entity66 @entity1755 @entity548 @entity177 @entity1167 @entity2333 @entity451 @entity912 @entity2332
Hypothermic cardiopulmonary bypass, usually in combination with an interval of @entity1167 , was used for the treatment of 211 @entity1 with extensive @entity2333 during a 17-year interval. Profound @entity2332 , distal perfusion, and intravenous @entity1667 and thiopental were used for neuroprotection. No other technique or other adjunctive agents were used. The 30-day mortality rate was 7.1% (15 @entity1 ). It was 40% (8 of 20) for @entity1 undergoing emergent operations for @entity1755 or acute dissection and 3.7% (7 of 191) for all other @entity1 (P<0.001). @entity451 occurred in 5 and paraparesis in 1 of the 205 operative survivors whose lower limb function could be assessed postoperatively (2.9%). Of the 121 survivors with @entity2333 , @entity451 occurred in 1 of 38 @entity1 with @entity66 (2.6%), 2 of 49 with type II (4.1%), and 2 of 34 with type III (5.9%). Paralysis developed in 1 (1.7%) of the 58 @entity1 who underwent aortic dissection. Renal dialysis was required in 6 (2.9%) of the 205 operative survivors, prolonged inotropic support (>48 hours) in 23 (11%), reoperation for @entity548 in 10 (5%), mechanical ventilation (>48 hours) in 50 (24%), and tracheostomy in 21 (10%). Four (1.9%) @entity1 sustained a @entity64 . Hypothermic cardiopulmonary bypass provides safe and substantial protection against @entity912 , and @entity177 that equals or exceeds that of other currently used techniques but without the need for other adjuncts.
