Newborn Aortic Arch Reconstruction With Descending Aortic Cannulation Improves Postoperative Renal Function James M. Hammel, MD, Joseph J. Deptula, MPS,

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Presentation transcript:

Newborn Aortic Arch Reconstruction With Descending Aortic Cannulation Improves Postoperative Renal Function James M. Hammel, MD, Joseph J. Deptula, MPS, Tara Karamlou, MD, MS, Elesa Wedemeyer, MAT, Ibrahim Abdullah, MD, Kim F. Duncan, MD The Annals of Thoracic Surgery Volume 96, Issue 5, Pages 1721-1726 (November 2013) DOI: 10.1016/j.athoracsur.2013.06.033 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Percentage of cases operated on during each calendar year using each technique. Although there is a substantial period of overlap, there is overall a clustering of patients into an earlier and a later era. (DAC = descending aortic cannulation; DHCA/SCP = deep hypothermic circulatory arrest with selective cerebral perfusion.) The Annals of Thoracic Surgery 2013 96, 1721-1726DOI: (10.1016/j.athoracsur.2013.06.033) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Patients undergoing selective cerebral perfusion with deep hypothermic circulatory arrest (DHCA/SCP) had consistently statistically higher postoperative creatinine changes from preoperative (Pre op) baseline compared with patients undergoing descending aortic cannulation (DAC; day 1–3, p ≤ 0.001; day 4, p = 0.001; day 5, p = 0.003). Dashed lines represent the interquartile range for DHCA/SCP; dotted lines represent the interquartile range for DAC. The Annals of Thoracic Surgery 2013 96, 1721-1726DOI: (10.1016/j.athoracsur.2013.06.033) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Patients undergoing selective cerebral perfusion with deep hypothermic circulatory arrest (DHCA/SCP) had significantly higher risk of RIFLE injury or failure compared with patients undergoing descending aortic cannulation (DAC) on the first three postoperative days. The Annals of Thoracic Surgery 2013 96, 1721-1726DOI: (10.1016/j.athoracsur.2013.06.033) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Patients undergoing selective cerebral perfusion with deep hypothermic circulatory arrest (DHCA/SCP) had a statistically significant higher risk of incurring creatinine values in the injury or risk categories as defined by RIFLE criteria compared with patients undergoing descending aortic cannulation (DAC) during the first five postoperative days. The Annals of Thoracic Surgery 2013 96, 1721-1726DOI: (10.1016/j.athoracsur.2013.06.033) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions