Predictors of Adverse Outcome and Transient Neurological Dysfunction Following Aortic Arch Replacement in 626 Consecutive Patients in China

Background Early mortality and cerebral injury are severe complications of aortic arch surgery, but data from Asian countries are scarce. We reviewed the results of patients who underwent aortic arch replacement with deep hypothermic circulatory arrest (DHCA) and antegrade selective cerebral perfusion (ASCP) at our institution to analyse pre- and intraoperative predictors of early death and neurological complications. Methods Clinical data of adult patients who underwent aortic arch surgery with DHCA plus ASCP between January 2005 and December 2011 were retrospectively analysed. Univariate and multivariate analyses were performed to identify predictors of adverse outcome defined as 30-day mortality and permanent neurological dysfunction (PND), and transient neurological dysfunction (TND). Results A total of 626 patients were included in the study. The average age of the patients was 45.0±10.7 years with male predominance (77.0%). The incidence of adverse outcome was 5.8%, consisting of 4.6% 30-day mortality and 1.9% PND. Transient neurological dysfunction was found in 13.9% patients. Multiple logistic regression showed that stroke (OR=7.846, 95% CI: 2.737-22.489, p