50
Volume 2, Issue 1, 2021. 50-59
DOI: 10.30546/azjcvs.2021.2.1.50
THE RISK OF RENAL AND NEUROLOGICAL
COMPLICATIONS AFTER RECONSTRUCTIVE SURGERY
OF THE AORTIC ARCH IN NEWBORNS
Yuriy SINELNIKOV ,
: https://orcid.org/0000-0002-8294-662X
Novosibirsk Research Institute of Blood Circulation Pathology of the Ministry of Health of the Russian
Federation, named after Meshalkin E; Russian Federation
Elnur HASANOV ,
: https://orcid.org/0000-0001-6695-5772
National Centre of Surgery of the Azerbaijani Ministry of Health,
named after Topchibashev, Baku, Azerbaijan
Faig MIRZAZADE
: https://orcid.org/0000-0001-5076-017X
National Centre of Surgery of the Azerbaijani Ministry of Health,
named after Topchibashev, Baku, Azerbaijan
ABSTRACT
When reconstructing the aortic arch (AA), it is necessary to select a method
that provides optimal protection of the internal organs and the brain. It was
previously believed that the hypothermic circulatory method was optimal.
However, recently, the application of antegrade cerebral perfusion with moderate
hypothermia has proved preferable when performing reconstructive operations
on the aorta on adult patients and some children. In these instances, continuous
cerebral perfusion reduces the incidence of neurological complications. However,
the degree of damage to the organ systems distal to the AA remains unclear.The
objective of this study was to assess the effectiveness and safety of various methods
for protecting the brain and internal organs during reconstructive operations
on the AA in small children. A retrospective analysis of 60 patients who had
received reconstructive operations on the AA was undertaken. The neurological
status and the degree of damage to internal organs in the short- and long-term,
combined with the application of various methods for protecting the brain, were
assessed. Surgical correction of the congenital pathology of the AA under deep
hypothermic circulatory arrest conditions was performed in 26 patients (Group I)
and antegrade unilateral selective perfusion of the brain was used for 34 patients
(Group II). Nervous system complications were detected in 28.5% of patients in
Group I, whereas it affected 7.9% of patients in Group II. Thus, the odds ratio for
development of the neurological case was signiϐicantly lower for Group II: 0.17
(0.06–0.69), p = 0.02. However, in this Group, patients with renal dysfunction
equated to 58.7%, whereas this ϐigure was 23.7% for Group I, p = 0.02.
Key words: AA reconstruction, newborn, profound hypothermia, antegrade
cerebral perfusion, renal dysfunction
ARTICLE INFO
Article type:
Original Article
Article history
Received:
05 September, 2020
Accepted:
27 December, 2020
Published:
29 January, 2021
© 2021 The Authors. This is an open-access article distributed
under the terms of the Creative Commons Attribution License.