Predictor of neurologic dysfunction after elective thoracic aorta repair using selective cerebral perfusion

Abstract

Objectives. This study was undertaken to determine the factors that influence postoperative neurological dysfunction after selective cerebral perfusion (SCP). Design. From 1995 to August 2004, 60 patients were evaluated for the presence of cerebro-vascular disease (CVD), and then underwent thoracic aortic operations using SCP. Perioperative factors were evaluated by multivariate analyses. Results. Hospital mortality rate was zero. Sixteen patients (26.7%) proved to have CVD. Permanent neurological dysfunction (PND) appeared in three patients (5.0%) and transient neurological dysfunction (TND) in two (3.3%). Univariate analysis revealed superficial temporal artery (STA) pressure during SCP (p = 0.0410) to be a significant risk factor for PAD. Variables that achieved values of p < 0.2 (aortic cross-clamp time, presence of CVD, old cerebral infarction, presence of clots or atheroma) were examined with multivariate analysis and the presence of CVD (p = 0.038) and STA pressure during SCP (p = 0.032) were independent risk factors for PAD. Multivariate analysis for TND did not show any risk factor. Conclusions. The presence of CVD was indicated as an independent risk factor for PND after thoracic aortic operations using SCP. © 2005 Taylor & Francis Group Ltd.