Key result
Cardiopulmonary bypass with selective perfusion during thoracoabdominal aortic repair significantly reduced mortality compared to left atrial-femoral bypass (3.8% vs 27.6%, p=0.003).
Why the study?
The study compared the effectiveness of left atrial-femoral bypass versus cardiopulmonary bypass with selective perfusion for visceral and renal protection during thoracoabdominal aortic repair.
Does cardiopulmonary bypass with selective perfusion improve clinical outcomes and reduce mortality compared to left atrial-femoral bypass in patients undergoing thoracoabdominal aortic repair?
Cohort (n=81)
No
Does cardiopulmonary bypass with selective perfusion improve clinical outcomes and reduce mortality compared to left atrial-femoral bypass in patients undergoing thoracoabdominal aortic repair?
Absolute Event Rate: 3.8% vs 27.6%
p-value: p=0.003
Cardiopulmonary bypass with selective visceral and renal perfusion significantly reduces mortality and organ dysfunction compared to left atrial-femoral bypass during thoracoabdominal aortic repair.
May support selective perfusion with cardiopulmonary bypass in thoracoabdominal aortic repair; leaves open randomized confirmation.
The objective: to compare the effectiveness of visceral and renal protection methods during thoracoabdominal aortic (TAA) repair: left atrial-femoral bypass (LAFB) and cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) of these organs. Subjects: 81 patients who underwent TAA repair were enrolled in retrospective analysis: LAFB was used in 29 patients (Group 1), CPB and SP ‒ in 52 patients (Group 2). Results. In Group 2, there were lower intraoperative blood loss volume (1,500 ml vs 4,200 ml, p < 0.001), significantly lower levels of direct bilirubin, blood creatinine, blood alpha-amylase in postoperative period, significantly shorter duration of hospital stay, ICU stay and duration of mechanical ventilation. Also in this group, there were lower incidence of multiple organ dysfunction (11.5% vs 37.9%, p = 0.005), stroke (0 vs 10.3%, p = 0.043), lower need for requirement (3.8% vs 20.7%, p = 0.022) and mortality (3.8% vs 27.6%, p = 0.003). Conclusion: During TAA repair, CPB in conjunction with selective visceral and renal perfusion is more beneficial for organ protection as compared with LAFB.
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Chepurnyak et al. (2021) conducted a cohort in Thoracoabdominal aortic (TAA) repair (n=81). Cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) vs. Left atrial-femoral bypass (LAFB) was evaluated on Mortality (p=0.003). Cardiopulmonary bypass with selective perfusion during thoracoabdominal aortic repair significantly reduced mortality compared to left atrial-femoral bypass (3.8% vs 27.6%, p=0.003).
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