Abstract
(1) Background: Deep hypothermic circulatory arrest (DHCA) with selective antegrade cerebral perfusion (ACP) is an established cerebral protection technique for the conduction of complex surgical procedures involving the aortic arch. It is controversial whether the duration of DHCA is associated with adverse outcome in patients with acute type A aortic dissection (AAAD). Our goal was to investigate whether DHCA time was associated with surgical outcome in patients undergoing a surgical treatment of AAAD. (2) Methods: A total of 410 patients were divided into two groups based on the DHCA time less than 60 min and equal to or longer than 60 min. (3) Results: Patients with longer DHCA times were significantly younger (p = 0.001). Intraoperatively, complex procedures with aortic arch surgery were more common in patients with longer DHCA times (p < 0.001). Accordingly, cardiopulmonary bypass (p < 0.001), cross-clamping (p < 0.001) and DHCA times (p < 0.001) were significantly longer in this group. Postoperatively, only the duration of mechanical ventilation (p < 0.001) and the rate of tracheotomy were significantly higher in these patients. Thirty-day mortality was satisfactory for both groups (p = 0.746). (4) Conclusions: Our results showed that improvements in perioperative management including ACP allow for the successful performance of surgical treatment of AAAD under DHCA with a duration of even longer than 60 min.
Highlights
Cerebral complications are a predominant cause of mortality and morbidity after thoracic aortic surgery [1]
Despite the benefits of Deep hypothermic circulatory arrest (DHCA) with SACP for vital organ support during complex cardiac surgery, some centers do not prefer its use to avoid the potential adverse impact of prolonged duration of circulatory arrest on postoperative renal function [5]. It is controversial if only the grade of hypothermia, the duration of DHCA or a combination of pre, intraand postoperative factors is associated with mortality in patients [6,7]
The aim of the present study was to investigate whether DHCA time is associated with the clinical outcome of patients undergoing surgical treatment of acute type A aortic dissection (AAAD)
Summary
Cerebral complications are a predominant cause of mortality and morbidity after thoracic aortic surgery [1]. DHCA with adjunctive selective antegrade cerebral perfusion (SACP) supports the protection of the central nervous system during a prolonged period of circularly arrest Despite the benefits of DHCA with SACP for vital organ support during complex cardiac surgery, some centers do not prefer its use to avoid the potential adverse impact of prolonged duration of circulatory arrest on postoperative renal function [5]. It is controversial if only the grade of hypothermia, the duration of DHCA or a combination of pre-, intraand postoperative factors is associated with mortality in patients [6,7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
