Neurologic and Renal Outcomes of Elective Proximal Aortic Repair and Current Cannulation Trends

Abstract

Background: We aimed to determine factors influencing neurologic dysfunction and acute kidney injury (AKI) in patients undergoing elective aortic aneurysm repair and we also investigated them according to cannulation sites. Methods: From January 2012 to April 2018, 112 patients received proximal aortic repair. We used aortic arch, axillary and femoral artery cannulation. Antegrade cerebral protection and total circulatory arrest were used. Results: We detected 6 (5.4%) transient and 6 (5.4%) permanent neurologic dysfunction. Peripheral arterial diseases, total bypass time, transfusion and AKI showed correlation with neurologic dysfunction. Peripheral arterial diseases and AKI were independent risk factors (p < 0.05). AKI was reported in 38 patients. Postoperative revision, cross-clamp time, total bypass time and total circulatory arrest showed correlation with AKI (p < 0.05). Patients with neurologic dysfunction (66%) and patients with AKI (63%) had more femoral cannulation. Conclusion: Proximal aortic repair can be achieved with low morbidity and mortality using appropriate cerebral protection and cannulation technique. Neurologic dysfunction and AKI are important factors for aortic surgery and femoral cannulation has the highest risk for neurologic dysfunction and AKI.