P018. A Novel Technique of Cerebral-body Separate Perfusion Combine with Mild Hypothermia During Acute Stanford A Aortic Dissection
Second Hospital of Jilin University
Jilin, Jilin
China - Contact Me
Dr Liu has been excellent in all kinds of aortic diseases such as acute aortic dissection, coronary artery bypass graft (CABG) in treating coronary artery disease and acute myocardial infarction, modified Maze procedure in ablation of atrial fibrillation, valve replacement and valvuloplasty, minimally invasive cardiac surgery, cardiac trauma, correction of various complex congenital heart diseases and surgical treatment of other common congenital and acquired cardiac diseases. He took the lead in carrying out surgical treatment of aortic diseases in the Northeast of China in 2005, especially in the surgical treatment of acute aortic dissection. Since 2009, professor Kexiang Liu has been devoting lots of efforts to the modifications of treatment of Stanford A aortic dissection, thus creating a novel technique. This novel modified surgical method not only reduces the blood loss, shortens operative time, but also improves the success rate of the surgery, simplifies the complexities of the traditional surgery patterns. The innovations of “Modified Stented-Graft” and “Stented-graft with Artificial Vascular Prothesis ” both obtained national patent. New Progress has been made remarkably since 2016 in the field that more than 50.8% of the aortic dissection surgeries have been performed without blood transfusions.Being the first to carry out independent coronary artery bypass graft (CABG) surgeries in Jilin Province, more than 95% are off-pump and the successful rate reaches more than 99% and the rate of no blood transfusion has reached 93%. Professor Kexiang Liu took the lead in performing hybrid operations containing multiple valve replacement, CABG and surgical ablation of atrial fibrillation. He has been promoting the use of autologous blood recovery technology and almost 73% of the operations are without blood transfusions.
Description
Oxygen saturation of superior and inferior vena cava was monitor and used for regulating the perfusion flow during cerebral-body separate. In brief, detect the superior vena cava oxygen saturation before CPB, 5 minutes during CPB, 10, 20 and 30 minutes during cerebral-body separate perfursion. Increase the perfusion flow if superior vena cava oxygen saturation lower than 65% or 10% of the oxygen saturation before CPB.
The operation was performed by the same surgeon in all patients. All the operations were successfully completed with no intra-operative death. The mean hypothermic circulatory arrest time was 5.79±0.6 minutes, cerebral perfusion flow was 800-1000 L.min-1, cerebral-body separate perfursion time was 40.07±8.78 min,
aortic cross-clamp time was 110.8±21.7, cardiopulmonary
bypass time was 141.8±19.3 min. Rectal
temperature at circulatory arrest
was 34.43±0.75℃.Minimum temperature at
circulatory arrest was 32.33±0.76 ℃.
There was 11 death in hospital. Consciousness recovery time was 4.85±1.97 h. Mechanical ventilation time was 23.8±24.46 h. There are 19 patients need CRRT. Neurological events especially transient consciousness disorder occurred in 4 patients, permanent consciousness disorder occurred in 2 patients. There were no early events, such as paraplegia, cerebral infarction, and limb ischemia. (Table 3)
Oxygen saturation of superior vena cava at 10, 20, 30, 40 minutes during cerebral-body separate was 70.95%, 71.30%, 72.03% and 72.9%. Inferior vena oxygen saturation was 63.95%, 62.94%, 63.92% and 69.1%. The perfusion flow was 1.73, 1.83, 1.82, 1.79 L.min-1.
Authors
kexiang liu (1), weitie wang (2)
Institutions
(1) N/A, Jilin, Jilin, (2) Department of Cardiovascular Surgery, The Second Hospital of Jilin University, Changchun, CA