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Deep Hypothermic Circulatory Arrest in the Elderly: Is it Safe?

Deep Hypothermic Circulatory Arrest in the Elderly: Is it Safe?. Adam D. Zimmet, Irving L. Kron, Alan M. Speir, Clifford E. Fonner, and Ivan K. Crosby University of Virginia Health Sciences Center, Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Charlottesville, VA.

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Deep Hypothermic Circulatory Arrest in the Elderly: Is it Safe?

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  1. Deep Hypothermic Circulatory Arrest in the Elderly: Is it Safe? Adam D. Zimmet, Irving L. Kron, Alan M. Speir, Clifford E. Fonner, and Ivan K. Crosby University of Virginia Health Sciences Center, Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Charlottesville, VA.

  2. Background • Increasing life expectancy in developed countries with changing indications for cardiac surgery • Today: More elderly patients undergoing cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest (DHCA)

  3. Purpose • To ascertain safety of DHCA in elderly patients undergoing thoracic aneurysm repair

  4. Methods • Retrospective review of prospectively collected data • Virginia Cardiac Surgery Quality Initiative (VCSQI) database

  5. Methods • 1358 patients for study period 2001-2008 • Analysis of patients aged under 75 and 75+ undergoing aneurysm repair with and without DHCA • Fisher’s exact test

  6. Baseline Characteristics

  7. Intra- & Postoperative Details

  8. With & Without DHCA

  9. Age & DHCA

  10. Discussion • Increasing numbers of elderly patients undergoing complex cardiac surgery • 13.7% mortality rate for age over 75 years undergoing thoracic aneurysm repair • 12.5% stroke rate

  11. Discussion • DHCA associated with trend towards increased risk of stroke in patients over 75 years of age • However no statistically significant differences in rates of reoperation for bleeding, renal failure, and mortality

  12. Conclusion • Elderly patients at increased risk of death, stroke following thoracic aneurysm repair • Combined with trend for increased risk of stroke, caution should be used when thoracic aneurysm repair requires DHCA in elderly patients

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