Role of Moderate Hypothermia and Antegrade Cerebral Perfusion during Repair of Type A Aortic Dissection
| Autor: | Marcos Nores, Sotiris C. Stamou, Brian D. Conway, Michael A. McHugh |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Aortic dissection
medicine.medical_specialty business.industry Incidence (epidemiology) 030204 cardiovascular system & hematology Hypothermia medicine.disease Cardiac surgery 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Moderate hypothermia Anesthesia Deep hypothermic circulatory arrest Medicine Cerebral perfusion pressure medicine.symptom Cardiology and Cardiovascular Medicine business Stroke |
| Zdroj: | International Journal of Angiology. 27:190-195 |
| ISSN: | 1615-5939 1061-1711 |
| DOI: | 10.1055/s-0038-1675204 |
| Popis: | The goal of this study was to compare early postoperative outcomes and actuarial survival between patients who underwent repair of acute type A aortic dissection with deep or moderate hypothermia.A total of 132 consecutive patients from a single academic medical center underwent repair of acute type A aortic dissection between January 2000 and June 2014. Of those, 105 patients were repaired under deep hypothermia (< 24 C°), while 27 patients were repaired under moderate hypothermia (≥24 C°). Median ages were 62 years (range: 27–86) and 59 years (range: 35–83) for patients repaired under deep hypothermia compared with patients repaired under moderate hypothermia, respectively (p = 0.451). Major morbidity, operative mortality, and 10-year actuarial survival were compared between groups.Operative mortality was 17.1 and 7.4% in the deep and moderate hypothermia groups, respectively (p = 0.208). Incidence of permanent stroke was 12.4% in the deep hypothermic circulatory arrest group and 0% in the moderate hypothermia group (p = 0.054). Actuarial 5- and 10-year survival demonstrated a trend for lower long-term mortality with moderate hypothermia compared with deep hypothermia (69% 5-year and 54% 10-year for deep hypothermia vs. 79% 5-year and 10-year for moderate hypothermia, log-rank p = 0.161).Moderate hypothermia is a safe and efficient alternative to deep hypothermia and may have protective benefits. Stroke rate was lower with moderate hypothermia. |
| Databáze: | OpenAIRE |
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