Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery - World Journal of Cardiovascular Surgery

WJCS > Vol.9 No.9, September 2019

Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery ()

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DOI: 10.4236/wjcs.2019.99012 883 Downloads 2,292 Views Citations

Author(s)

Koji Furukawa^*, Kosuke Mori, Yukie Shirasaki, Hirohito Ishii, Kunihide Nakamura

Affiliation(s)

Department of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

ABSTRACT

Objectives: To investigate the influence of cold renal perfusion on renal function and clinical outcomes in cases where the renal ischemia time exceeded 30 min during pararenal and juxtarenal abdominal aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four patients who underwent open repair for P/JAAAs were retrospectively analyzed. Thirty-nine patients received renal perfusion with cold Ringer’s solution (perfusion group) and 15 patients did not receive renal perfusion (non-perfusion group). There were no significant differences in preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71 mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs. 2/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping (49 ± 21 vs. 47 ± 11 min; p = 0.8) between the groups. Postoperative Cr was significantly lower in the perfusion group than in the non-perfusion group (1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p < 0.01). The percentage of patients with postoperative Cr > 2 mg/dL was also significantly lower in the perfusion group than in the non-perfusion group [5 (13%) vs. 7 (47%), p < 0.01)]. At discharge, Cr returned to preoperative levels in both groups. All patients were discharged from the hospital without incidents. Conclusion: Renal artery perfusion with cold Ringer’s solution clearly reduced the deterioration of postoperative renal function compared to non-renal perfusion.

KEYWORDS

Cold Renal Perfusion, Pararenal Abdominal Aortic Aneurysm, Juxtarenal Abdominal Aortic Aneurysm, Suprarenal Clamping, Renal Function

Share and Cite:

Furukawa, K. , Mori, K. , Shirasaki, Y. , Ishii, H. and Nakamura, K. (2019) Significance of Cold Renal Perfusion on Renal Function and Clinical Outcomes When Renal Ischemia Time Exceeded 30 Min during Pararenal and Juxtarenal Abdominal Aortic Aneurysm Surgery. World Journal of Cardiovascular Surgery, 9, 97-107. doi: 10.4236/wjcs.2019.99012.

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