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Reoperation of the proximal aorta: impact of presternotomy extracorporeal circulation on clinical outcomes

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Abstract

Purpose

Adverse events can occur during a sternotomy for reoperation of the proximal aorta. Presternotomy extracorporeal circulation is often employed to avoid catastrophic events. The purpose of this study was to investigate the impact of presternotomy extracorporeal circulation on clinical outcomes of redo proximal aortic surgery.

Methods

Between January1990 and December 2005 a total of 21 aneurysms or dissections of the proximal aorta were repaired via a repeat sternotomy. Extracorporeal circulation was established before the sternotomy in 9 (49%) patients and after the sternotomy in 12 (51%) patients.

Results

There were no statistically significant differences in the age, sex, emergency surgery, chronic obstructive pulmonary disease, and renal function between the groups. Femoral cannulation was used more often in the presternotomy extracorporeal circulation group (8/9, 89% vs. 1/12, 8.3%; P = 0.000). The difference in the pump time did not reach a statistically significant level. The 30-day and in-hospital mortality rates were 11% (1/9) and 11% (1/9) in the presternotomy extracorporeal circulation group and 0% (0/12) and 17% (2/12) in the poststernotomy extracorporeal circulation group. There were no statistically significant differences in stroke, respiratory failure, myocardial infarction, or renal failure. There was a trend toward a longer hospital stay in the presternotomy extracorporeal circulation group (85.8 vs. 48.1 days; P = 0.06).

Conclusion

Presternotomy extracorporeal circulation was not associated with any major adverse outcomes such as death, stroke, or renal failure.

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References

  1. Estrera AL, Miller CC 3rd, Porat E, Mohamed S, Kincade R, Huynh TT, et al. Determinants of early and late outcome for reoperations of the proximal aorta. Ann Thorac Surg 2004;78: 837–845; discussion 837–45.

    Article  PubMed  Google Scholar 

  2. Roselli EE, Pettersson GB, Blackstone EH, Brizzio ME, Houghtaling PL, Hauck R, et al. Adverse events during reoperative cardiac surgery: frequency, characterization, and rescue. J Thorac Cardiovasc Surg 2008;135:316–323, 323 e1–6.

    Article  PubMed  Google Scholar 

  3. Dobell AR, Jain AK. Catastrophic hemorrhage during redo sternotomy. Ann Thorac Surg 1984;37:273–278.

    Article  CAS  PubMed  Google Scholar 

  4. Luciani N, Anselmi A, De Geest R, Martinelli L, Perisano M, Possati G. Extracorporeal circulation by peripheral cannulation before redo sternotomy: indications and results. J Thorac Cardiovasc Surg 2008;136:572–577.

    Article  PubMed  Google Scholar 

  5. Kuralay E, Bolcal C, Cingoz F, Gunay C, Yildirim V, Kilic S, et al. Cardiac reoperation by Carpentier bicaval femoral venous cannula: GATA experience. Ann Thorac Surg 2004;77:977–981; discussion 982.

    Article  PubMed  Google Scholar 

  6. Follis FM, Pett SB Jr, Miller KB, Wong RS, Temes RT, Wernly JA. Catastrophic hemorrhage on sternal reentry: still a dreaded complication? Ann Thorac Surg 1999;68:2215–2219.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Social Insurance Chukyo Hospital, 1-1-10 Sanjyo, Minami-ku, Nagoya, 457-8510, Japan

    Tomonobu Abe

  2. Graduate School of Medicine, Nagoya University, Nagoya, Japan

    Akihiko Usui, Hideki Oshima & Yuichi Ueda

  3. Department of Cardiovascular Surgery, Toyota Kosei Hospital, Toyota, Japan

    Masaharu Yoshikawa

  4. Department of Cardiovascular Surgery, Kanazawa Medical University, Ishikawa, Japan

    Toshiaki Akita

Authors
  1. Tomonobu Abe
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  2. Akihiko Usui
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  3. Masaharu Yoshikawa
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  4. Hideki Oshima
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  5. Toshiaki Akita
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  6. Yuichi Ueda
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Corresponding author

Correspondence to Tomonobu Abe.

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Abe, T., Usui, A., Yoshikawa, M. et al. Reoperation of the proximal aorta: impact of presternotomy extracorporeal circulation on clinical outcomes. Gen Thorac Cardiovasc Surg 57, 458–462 (2009). https://doi.org/10.1007/s11748-009-0432-2

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  • DOI: https://doi.org/10.1007/s11748-009-0432-2

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