Large vascular surgery in the management of cardiopulmonary bypass.docVIP

 PAGE \* MERGEFORMAT 13 Large vascular surgery in the management of cardiopulmonary bypass Author: Gary Wang, Li Jia-chun, Gao Changqing, DING Zhen-yuan, Luo loyal, Zhang Tao [Abstract] Objective To evaluate a variety of major vascular surgery in cardiopulmonary bypass (extracorporeal circulation, ECC) methods and management experience. Methods ECC to complete a variety of major vascular surgery 61 patients, ascending aortic graft replacement, Bentall procedure using the ascending aorta - right atrial cannulation, the hypothermic cardiopulmonary bypass; l primary and semi-arch replacement surgery using axillary artery - right atrium intubation, deep hypothermic circulatory arrest method; total aortic arch replacement (elephant trunk technique) with stent implantation using axillary artery - right atrium cannulation, deep hypothermic circulatory arrest + antegrade cerebral perfusion. 4:1 Han Xue myocardial protection are used antegrade cold cardioplegia + retrograde perfusion method. Results l main and semi-arch replacement in 10 cases, Bentall operation 33 cases, Cabrol + semi-arch replacement surgery, 1 case, Bentall + l primary and semi-arch replacement surgery in 9 cases, Bentall + arch replacement (elephant trunk technique) with stent implantation in 2 cases or the primary and full arch replacement with stent implantation in 5 cases, David procedure in 1 case, the same period in coronary artery bypass grafting in 5 cases. Use of axillary artery cannulation in 27 cases. ECC time of 129 ~ 414 (182.3 ± 51.9) min, aortic clamping time 68 ~ 259 (137.0 ± 35.0) min, minimum nasopharyngeal temperature 13.8 ~ 28.0 (22.8 ± 3.5) ℃ , deep hypothermic circulatory arrest in 26 cases, stop cycle time of 15 ~ 55 (29.2 ± 11.4) min, circulatory arrest, when the minimum nasopharyngeal temperature 13.8 ~ 21.0 (17.7 ± 1.9) ℃ , change in urine flow 150 ~ 4900 (1326.1 ± 1061.2) ml, ultrafiltration volume of 900 ~ 5000 (2783.9 ± 1246.6) ml, postoperative ventilation time