Optimal Degree of Hypothermia in Total Arch Replacement for Type A Aortic Dissection

Wu, Jinlin; Qiu, Juntao; Fang, Zhongrong; Luo, Qipeng; Huang, Yao; Yu, Cuntao; Wang, Guyan

doi:10.3389/fcvm.2021.668333

Cited by 7 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with the other three groups, the incidence of MFS was lowest in the group [2,15] (p = 0.036). The incidence of this ABO was highest (80 (24.3%), p <0.001) and traditional TAR+FET was lowest [241 (73.3%), p < 0.001] and statistically significant in group [2,15]. From group [2,15] to (22,73], the CPB time and HCA time were gradually prolonged, and an increase was therefore seen in surgical mortality rate (p = 0.014).…”

Section: Characteristics Before Psmmentioning

confidence: 80%

Section: Characteristics Before Psmmentioning

confidence: 96%

“…Before matching, there was a statistically significant difference in age among four groups: group [2,15] was the oldest and group (18,22] was the youngest. Compared with the other three groups, the incidence of MFS was lowest in the group [2,15] (p = 0.036). The incidence of this ABO was highest (80 (24.3%), p <0.001) and traditional TAR+FET was lowest [241 (73.3%), p < 0.001] and statistically significant in group [2,15].…”

Section: Characteristics Before Psmmentioning

confidence: 96%

“…About 1,018 patients were divided into four quartile groups based on HCA time. HCA time between 2 min (inclusive) and 15 min (inclusive) was defined as [2,15] group, between 15 min and 18 min (inclusive) was defined as (15,18] Abbreviations: HCA, hypothermia circulatory arrest; TAAD, type A aortic dissection; TAR, total arch replacement; ABO, aortic balloon occlusion; DHCA, deep hypothermic cardiac arrest; MHCA, moderate hypothermic cardiac arrest; ACP, antegrade cerebral perfusion; RCP, retrograde cerebral perfusion; CRRT, continuous renal replacement therapy. group, and so on remaining two groups, i.e., (18,22], (22,73] groups, were defined.…”

Section: Patients and Definitionmentioning

confidence: 99%

“…Many aortic surgery centers have focused on the effects of different core temperatures and assisted cerebral perfusion strategies on surgical outcomes (10)(11)(12)(13)(14), while few studies have addressed the effect of duration of HCA on the overall patient population. Our team has also recently studied HCA temperature and brain protection strategies demonstrating that moderate HCA (MHCA) combined with antegrade cerebral perfusion (ACP) is a safe and effective technique for TAAD (15). Therefore, the purpose of this study was to clarify the relationship between HCA time and early postoperative outcomes based on our singlecenter clinical experience.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience

Song

Sun

et al. 2021

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Objective: The duration of hypothermic circulatory arrest (HCA) is one of the important factors affecting the prognosis of arch surgery, which is still controversial. The purpose of this study was to investigate the effect of HCA duration on early prognosis in type A aortic dissection (TAAD) patients who underwent arch surgery in our center.Methods: All consecutive patients who underwent surgical treatment for TAAD in Fuwai Hospital from January 2013 to December 2018 were included in this study and divided into four quartile groups based on HCA time. Baseline characteristics, perioperative indicators, and early mortality were statistically analyzed by propensity score matching (PSM) and restricted cubic spline (RCS) method. Perioperative adverse events were confirmed according to the American STS database and Penn classification.Results: About 1,018 consecutive patients (mean age 49.11 ± 1.4 years, male 74.7%) with TAAD treated surgically were eventually included in this study. After PSM, with the prolongation of HCA time, the surgical mortality rates of group [2,15], (15,18], (18,22], and (22,73] were 4.1, 6.6, 7.8, and 10.9% with p = 0.041, respectively. As shown in RCS, the mortality rate increased sharply after the HCA time exceeded 22 min. And from the subgroup analysis, the HCA time of 22 min or less was associated with better clinical outcomes (OR 2.09, 95%CI 1.25–3.45, p = 0.004).Conclusions: The early mortality increases significantly with the duration of HCA time when arch surgery was performed. And multiple systems throughout the body can be adversely affected.

show abstract

Section: Characteristics Before Psmmentioning

confidence: 80%

Section: Characteristics Before Psmmentioning

confidence: 96%

Section: Characteristics Before Psmmentioning

confidence: 96%

Section: Patients and Definitionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience

Song

Sun

et al. 2021

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

Comparing unilateral and bilateral cerebral perfusion during total arch replacement for acute type A aortic dissection

Ji,

Qiu,

Zhang

et al. 2024

Interdisciplinary CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

OBJECTIVES To assess the effects of unilateral versus bilateral antegrade cerebral perfusion (u-ACP vs b-ACP) on postoperative complications and mid-term follow-up results in Asian patients with acute type A aortic dissection (ATAAD) undergoing total arch replacement (TAR) + the frozen elephant trunk (FET). METHODS Clinical baseline data and postoperative complications of 702 ATAAD patients undergoing TAR+ FET at China Cardiovascular Centre Fuwai Hospital between January 2019 and December 2022 were collected. Patients were categorized into two groups based on antegrade cerebral perfusion: unilateral (n = 402) and bilateral (n = 300). Propensity scores were matched for 217 pairs of patients. Mid-term and perioperative surgical complications were analyzed, and baseline characteristics between the two groups were assessed. RESULTS The matched cohort revealed comparable 30-day mortality rates between u-ACP and b-ACP: 4.15% and 3.23%, respectively (p = 0.61). Rates of postoperative permanent neurologic dysfunction (PND) were similar across groups (2.76% for u-ACP and 3.23% for b-ACP, p = 0.76). However, u-ACP exhibited a higher incidence of postoperative transient neurologic deficit (TND) at 14.29% compared to 6.91% with b-ACP (p = 0.01). Logistic regression models identified u-ACP and cardiopulmonary bypass (CPB) time as independent risk factors for TND. Mid-term survival rates were comparable between the two groups (5-year survival: 90.29% vs 93.67%, p = 0.133). CONCLUSIONS Both u-ACP and b-ACP are effective brain protection techniques for ATAAD patients undergoing total arch replacement. The use of b-ACP significantly reduces the incidence of TND.

show abstract

Aortic balloon occlusion simplifies dissected thoracoabdominal aortic aneurysm repair after frozen elephant trunk

Yang

et al. 2022

Journal of Cardiac Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Optimal Degree of Hypothermia in Total Arch Replacement for Type A Aortic Dissection

Cited by 7 publications

References 10 publications

It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience

It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience

Comparing unilateral and bilateral cerebral perfusion during total arch replacement for acute type A aortic dissection

Aortic balloon occlusion simplifies dissected thoracoabdominal aortic aneurysm repair after frozen elephant trunk

Contact Info

Product

Resources

About