抄録
Prolonged cardiopulmonary bypass (CPB) over 4 hours have been known to have high morbidity and high operative mortality. Out of 118 cases, which required prolonged CPB over 4 hours in last 10 years (incidence 6.2%), 65 cases were analyzed. The operative mortality was 54.3% before starting the use of cardioplegia, and 26.3% in last 4 years with the utilization of cardioplegia. In 19 cases during last 4 years, the postoperative serum creatinine (s-cr) was significantly high in operative death group compared to the survived group (mean 4.10±2.18 vs 1.67±1.20, p<0.025). Regarding the postoperative organ function, congenital heart group showed significant elevation of s-cr level, and decrease in Pao2 and platelet count. In acquired heart group, cardiac index and platelet count were significanly low compared to the control group (CPB less than 4hrs). Utilization of membrane oxygenator indicated the tendencies of low s-cr level compared to the bubble oxygenator. This study showed that prolonged CPB over 4 hours had significant influence on renal function, and the association of postoperative renal failure increased the operative mortality.
