Different hypothermic and cerebral perfusion strategies in extended arch replacement for acute type a aortic dissection: a retrospective comparative study

Autor: Song-Bo Dong, Jian-Xian Xiong, Kai Zhang, Jun Zheng, Shang-Dong Xu, Yong-Min Liu, Li-Zhong Sun, Xu-Dong Pan
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 15, Iss 1, Pp 1-8 (2020)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-020-01284-y
Popis: Abstract Background The optimal hypothermic level in total arch replacement with stented elephant trunk implantation for acute type A aortic dissection (aTAAD) has not been established, and the superiority of unilateral or bilateral cerebral perfusion remains a controversial issue. Therefore, we evaluated the application of moderate hypothermic circulatory arrest (MHCA) with a core temperature of 29 °C and bilateral selective antegrade cerebral perfusion in aTAAD treated by total arch replacement with stented elephant trunk implantation. Methods From July 2019 to January 2020, 25 aTAAD patients underwent total arch replacement with stented elephant trunk implantation via MHCA (29 °C) and bilateral selective antegrade cerebral perfusion (modified group). Thirty-six patients treated by the same procedure with MHCA (25 °C) and unilateral selective antegrade cerebral perfusion during this period were selected as controls. Results There were no differences between the two groups of patients in terms of age, sex, incidence of hypertension, malperfusion, and pericardial effusion, although the incidence of cardiac tamponade was higher in the modified group (control 2.8%, modified 20%; P = 0.038). The lowest mean circulatory arrest temperature was 24.6 ± 0.9 °C in the control group, and 29 ± 0.8 °C in the modified group (P
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