Bilateral selective antegrade cerebral perfusion for aortic arch surgery: Safe and reproducible for low volume aortic surgeons – A single centre experience

(COPD), underlying renal impairment and Marfan’s syndrome. We also included underlying valvular heart disease, coronary artery disease, haemopericardium, preoperative hypotension in this study. Besides that, we also looked into type of surgery, use of ACP, duration of cardiopulmonary bypass (CPB), duration of cross-clamp, duration of HCA and temperature during HCA in this study. Outcome predictors were temporary neurological deficit (TND), stroke and mortality during same admission. Results: Temporary neurological deficit (TND)was seen in 17 patients (56.6%) while stroke was seen in 3 patients (10%). Mortality rate was 26.6% (8 patients). Univariate analysis for neurological outcome indicated that underlying renal impairment was significant (p=0.032) but no factors were found to be significant in multivariate analysis. Univariate analysis for early mortality showed that age above 60 years (p=0.01), intraoperative arch replacement (p=0.04), HCA timemore than 60mins (p=0.04), preoperative hypotension (p=0.001) and post-operative pulmonary complication (p=0.023) were significant factors. Multivariate analysis however showed that only preoperative hypotension (p=0.017) and post-operative pulmonary complications (p=0.034) were factors significantly affecting early mortality. Conclusion: Our study indicated that preoperative hypotension and post-operative pulmonary complications were factors which significantly affected early mortality while there were no factors which significantly affected neurological outcome.