The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Rizun L.I.

Petrovsky National Research Center of Surgery

Vinokurov I.A.

Sechenov First Moscow State Medical University

Akselrod B.A.

Petrovsky National Research Center of Surgery

Eremenko A.A.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University

Charchyan E.R.

Petrovsky National Research Center of Surgery

Belov Yu.V.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University

Blood loss as the main cause of organ dysfunction after simultaneous ascending aorta and aortic arch replacement

Authors:

Rizun L.I., Vinokurov I.A., Akselrod B.A., Eremenko A.A., Charchyan E.R., Belov Yu.V.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(1): 63‑69

DOI: 10.17116/kardio20241701163

Read: 1453 times

Contact the author
Table of contents

BLOOD LOSS AS THE MAIN CAUSE OF ORGAN DYSFUNCTION AFTER SIMULTANEOUS ASCENDING AORTA AND AORTIC ARCH REPLACEMENT
BLOOD LOSS AS THE MAIN CAUSE OF ORGAN DYSFUNCTION AFTER SIMULTANEOUS ASCENDING AORTA AND AORTIC ARCH REPLACEMENT

To cite this article:

Rizun LI, Vinokurov IA, Akselrod BA, Eremenko AA, Charchyan ER, Belov YuV. Blood loss as the main cause of organ dysfunction after simultaneous ascending aorta and aortic arch replacement. Russian Journal of Cardiology and Cardiovascular Surgery. 2024;17(1):63‑69. (In Russ.)
https://doi.org/10.17116/kardio20241701163

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Asse­ssment of turbulent blood flow and wall shear stress in asce­nding aortic aneurysms. Russian Journal of Cardiology and Cardiovascular Surgery. 2025;(3):351-351
Early and late outcomes of retroperitoneal thoracophrenolumbotomy healing following open repair of thoracoabdominal aortic aneurysm and mega-aortic syndrome: a 15-year single-center expe­rience. Russian Journal of Cardiology and Cardiovascular Surgery. 2026;(2):5-13
Electroneuromyography with bipo­lar stimulation probe for inte­rcostal nerve cryoablation after thoracoabdominal aortic aneurysm and mega aorta repair. Russian Journal of Cardiology and Cardiovascular Surgery. 2026;(2):14-21
Transesophageal echo­cardiography for diagnosis of turbulent blood flow in asce­nding aorta dissection. Piro­gov Russian Journal of Surgery. 2025;(10-2):12-17
Resu­lts of complex endo­vascular aortic repair with preservation of visceral brunch perfusion. Piro­gov Russian Journal of Surgery. 2025;(10-2):18-28
Algo­rithm for calculating the volume of primary tangential wound exci­sion in surgical treatment of patients with burn disease during the period of burn toxe­mia. Russian Journal of Operative Surgery and Clinical Anatomy. 2025;(4):30-38
Pathomorphological features of various etiological forms of aortic aneurysm. Russian Journal of Archive of Pathology. 2026;(2):43-51
Abstract:

OBJECTIVE

To study the effect of intraoperative blood loss on postoperative outcomes in patients with aneurysm and/or dissection of ascending aorta and aortic arch.

MATERIAL AND METHODS

A retrospective analysis included 77 patients (mean age 52.8±11.4 years). All ones underwent ascending aorta and aortic arch replacement under cardiopulmonary bypass and antegrade cerebral perfusion with hypothermia (mean 23.9±3.2 °C) for aneurysm and/or dissection. To identify the relationship between blood loss and incidence of organ dysfunctions, we used the original parameter, i.e. blood loss index (intraoperative blood loss / weight / surgery time) (ml/kg/hour).

RESULTS

There was a significant correlation between blood loss index and postoperative organ dysfunctions (r=0.57, p<0.001). At the same time, we found no correlation between overall blood loss and postoperative organ dysfunctions (r=0.23, p=0.23). According to the ROC curve, the cut-off values were 2.9 ml/kg/hour for respiratory failure, 3.1 ml/kg/hour for cardiovascular failure and 6 ml/kg/hour for multiple organ failure. Sensitivity of each point was 72%, 81% and 84%, specificity 59%, 59% and 64%, respectively.

CONCLUSION

Blood loss index is valuable to predict organ dysfunctions after ascending aorta and aortic arch surgery. The conditionally «safe» blood loss index is less than 3 ml/kg/hour.

Keywords:

aortic aneurysm
aortic dissection
intraoperative blood loss
blood loss index

Authors:

Rizun L.I.

Petrovsky National Research Center of Surgery

Vinokurov I.A.

Sechenov First Moscow State Medical University

Akselrod B.A.

Petrovsky National Research Center of Surgery

Eremenko A.A.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University

Charchyan E.R.

Petrovsky National Research Center of Surgery

Belov Yu.V.

Petrovsky National Research Center of Surgery;
Sechenov First Moscow State Medical University

Received:

11.08.2022

Accepted:

12.09.2022

Close metadata

References:

  1. Bokeriya LA, Milievskaya EB, Kudzoeva ZF, Pryanishnikov VV, Skopin AI, Yurlov IA. Cardiovascular surgery — 2018. Diseases and congenital anomalies of cardiovascular system. M.: NMITsSSKh im. A.N. Bakuleva MZ RF; 2019. (In Russ.).
  2. Belov YuV, Komarov RN. Handbook for thoracoabdominal aortic aneurysm surgery. M.: MIA; 2010. (In Russ.).
  3. Semsroth S, Dumfarth J, Schachner T, et al. Das akute Aortensyndrom. Medizinische Klinik — Intensivmedizin und Notfallmedizin. 2014;109(5):371-384.  https://doi.org/10.1007/s00063-014-0391-y
  4. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). European Heart Journal. 2014;35(41):2873-2926. https://doi.org/10.1093/eurheartj/ehu281
  5. Keshavamurthy S, Mick SL, Damasiewicz H, Sabik JF. Bovine Pericardial Wrap for Intractable Bleeding After Graft Replacement of the Ascending Aorta. The Annals of Thoracic Surgery. 2015;100(2):735-737.  https://doi.org/10.1016/j.athoracsur.2015.03.042
  6. Natour E, Suedkamp M, Dapunt OE. Assessment of the effect on blood loss and transfusion requirements when adding a polyethylene glycol sealant to the anastomotic closure of aortic procedures: a case-control analysis of 102 patients undergoing Bentall procedures. Journal of Cardiothoracic Surgery. 2012;7:105.  https://doi.org/10.1186/1749-8090-7-105
  7. Boudart A, Yilmaz A, Kaya A. Minimal access compared to sternotomy for aortic root and arch surgery. Acta Chir Belg. 2022;122(2):144-149.  https://doi.org/10.1080/00015458.2022.2050979
  8. Tenorio ER, Oderich GS, Kölbel T, Dias NV, Sonesson B, Karelis A, Farber MA, Parodi FE, Timaran CH, Scott CK, Tsilimparis N, Fernandez C, Jakimowicz T, Jama K, Kratzberg J, Mougin J, Haulon S. Multicenter global early feasibility study to evaluate total endovascular arch repair using three-vessel inner branch stent-grafts for aneurysms and dissections. J Vasc Surg. 2021;74(4):1055-1065.e4.  https://doi.org/10.1016/j.jvs.2021.03.029
  9. Zhang L, Yu C, Chang Q, Sun X, Qian X, Luo X, Wei B. [Surgical outcomes of off-pump technique in extensive thoracoabdominal aorta replacement]. Zhonghua Wai Ke Za Zhi. 2016;54(2):119-124 Chinese. https://doi.org/10.3760/cma.j.issn.0529-5815.2016.02.009
  10. Martens A, Koigeldiyev N, Beckmann E, Fleissner F, Kaufeld T, Krueger H, Stanelle D, Puntigam J, Haverich A, Shrestha M. Do not leave the heart arrested. Non-cardioplegic continuous myocardial perfusion during complex aortic arch repair improves cardiac outcome. Eur J Cardiothorac Surg. 2016;49(1):141-148.  https://doi.org/10.1093/ejcts/ezv009
  11. Tanaka Y, Mikamo A, Suzuki R, Kurazumi H, Kudo T, Takahashi M, Ikenaga S, Shirasawa B, Hamano K. Mortality and morbidity after total aortic arch replacement. Ann Thorac Surg. 2014;97(5):1569-1575. https://doi.org/10.1016/j.athoracsur.2014.01.014
  12. Li J, Li L, Wang M, Li H, Sun L, Liu Y, Fan R, Zhang Z, Zou C, Zhang H, Gong M. Comparison of Prognosis Between Hybrid Debranching Surgery and Total Open Arch Replacement With Frozen Elephant Trunk for Type A Acute Aortic Syndrome Patients. Front Cardiovasc Med. 2021;8:689507. https://doi.org/10.3389/fcvm.2021.689507
  13. Liu T, Fu Y, Liu J, Liu Y, Zhu J, Sun L, Gong M, Dong R, Zhang H. Body mass index is an independent predictor of acute kidney injury after urgent aortic arch surgery for acute DeBakey Type I aortic dissection. J Cardio thorac Surg. 2021;16(1):145.  https://doi.org/10.1186/s13019-021-01533-8
  14. Belov IuV, Charchian ÉR, Stepanenko AB, Gens AP, Khachatryan ZR. Surgical treatment of DeBakey type 1 aortic dissection. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2018;(7):8-17. (In Russ.). https://doi.org/10.17116/hirurgia201878
  15. Boening A, Karck M, Conzelmann LO, Easo J, Krüger T, et al. German Registry for Acute Aortic Dissection Type A: Structure, Results, and Future Perspectives. The Thoracic and Cardiovascular Surgeon. 2017;65(2):77-84.  https://doi.org/10.1055/s-0036-1572436
  16. Nakamura T, Mikamo A, Matsuno Y, Fujita A, Kurazumi H, Suzuki R, Hamano K. Impact of acute kidney injury on prognosis of chronic kidney disease after aortic arch surgery. Interact Cardiovasc Thorac Surg. 2020;30(2):273-279.  https://doi.org/10.1093/icvts/ivz247
  17. Belov YuV, Charchyan ER, Vinokurov IA. Problem of cerebral protection during operations on aortic arch. Kardiologiya i serdechno-sosudistaya khirurgiya. 2013;6(1):40-42. (In Russ.).
  18. Colli A, Carrozzini M, Francescato A, et al. Acute DeBakey Type I aortic dissection without intimal tear in the arch: is total arch replacement the right choice? Interactive CardioVascular and Thoracic Surgery. 2018;26(1):84-90.  https://doi.org/10.1093/icvts/ivx229
  19. Dumfarth J, Kofler M, Stastny L, Plaikner M, Krapf C, et al. Stroke after emergent surgery for acute type A aortic dissection: predictors, outcome and neurological recovery. European Journal of Cardio-Thoracic Surgery. 2018;53(5):1013-1020. https://doi.org/10.1093/ejcts/ezx465
  20. Dyke C, Aronson S, Dietrich W, Hofmann A, Karkouti K, et al. Universal definition of perioperative bleeding in adult cardiac surgery. The Journal of Thoracic and Cardiovascular Surgery. 2014;147(5):1458-1463.e1.  https://doi.org/10.1016/j.jtcvs.2013.10.070
  21. Petrou A, Tzimas P, Siminelakis S. Massive bleeding in cardiac surgery. Definitions, predictors and challenges. Hippokratia. 2016;20(3):179-186. 
  22. Pagano D, Milojevic M, Meesters MI, Benedetto U, Bolliger D, von Heymann C, Jeppsson A, Koster A, Osnabrugge RL, Ranucci M, Ravn HB, Vonk ABA, Wahba A, Boer C. 2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery. Eur J Cardiothorac Surg. 2018;53(1):79-111.  https://doi.org/10.1093/ejcts/ezx325
  23. Settepani F, Cappai A, Basciu A, Barbone A, Tarelli G. Outcome of open total arch replacement in the modern era. Journal of Vascular Surgery. 2016;63(2):537-545.  https://doi.org/10.1016/j.jvs.2015.10.061
  24. Chu MW, Losenno KL, Moore K, Berta D, Hewitt J, Ralley F. Blood conservation strategies reduce the need for transfusions in ascending and aortic arch surgery. Perfusion. 2013;28(4):315-321.  https://doi.org/10.1177/0267659113479816
  25. Trekova NA, Charchyan ER, Akselrod BA, Seleznev MN, Guskov DA, Solovyeva IN. Modern technologies of blood sparing and reduction of donor blood transfusion in ascending aorta and aortic arch surgery. Anesteziol Reanimatol. 2015;60(5):20-26. (In Russ.).
  26. St-Onge S, Lemoine É, Bouhout I, Rochon A, El-Hamamsy I, Lamarche Y, Demers P. Evaluation of the real-world impact of rotational thromboelastometry-guided transfusion protocol in patients undergoing proximal aortic surgery. J Thorac Cardiovasc Surg. 2019;157(3):1045-1054.e4.  https://doi.org/10.1016/j.jtcvs.2018.07.043
  27. JR, Steiner ME, Stowell CP, Sloan SR. Massive Transfusion in Cardiac Surgery: The Impact of Blood Component Ratios on Clinical Outcomes and Survival. Anesth Analg. 2017;124(6):1777-1782. https://doi.org/10.1213/ane.0000000000001926
  28. Pupovac SS, Hemli JM, Scheinerman SJ, Hartman AR, Brinster DR. Transfusion in Elective Proximal Aortic Reconstruction: Where Do We Currently Stand? Int J Angiol. 2021;30(4):292-297.  https://doi.org/10.1055/s-0041-1729860
  29. Velasquez CA, Singh M, Bin Mahmood SU, Brownstein AJ, Zafar MA, Saeyeldin A, Ziganshin BA, Elefteriades JA. The Effect of Blood Transfusion on Outcomes in Aortic Surgery. Int J Angiol. 2017;26(3):135-142.  https://doi.org/10.1055/s-0037-1604417
  30. Bartoszko J, Wijeysundera DN, Karkouti K, Callum J, Rao V, Crowther M, Grocott HP, Pinto R, Scales DC, Achen B, Brar S, Morrison D, Wong D, Bussières JS, de Waal T, Harle C, de Médicis É, McAdams C, Syed S, Tran D, Waters T; Transfusion Avoidance in Cardiac Surgery Study Investigators. Comparison of Two Major Perioperative Bleeding Scores for Cardiac Surgery Trials: Universal Definition of Perioperative Bleeding in Cardiac Surgery and European Coronary Artery Bypass Grafting Bleeding Severity Grade. Anesthesiology. 2018;129(6):1092-1100. https://doi.org/10.1097/ALN.0000000000002179
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.