Mild Hypothermic Circulatory Arrest with Lower Body Perfusion for Total Arch Replacement Via Upper Hemisternotomy in Acute Type A Dissection

© 2021 Forum Multimedia Publishing, LLC.

BACKGROUND: Mild hypothermia circulatory arrest combined with lower body perfusion (LBP) might be beneficial for the recovery of patients with acute type A dissection. However, the safety of mild hypothermic circulatory arrest with LBP used in total arch replacement combined with frozen elephant trunk implantation (FET) via single upper hemisternotomy approach is ambiguous.

METHODS: We retrospectively analyzed 70 consecutive patients with acute type A dissections who underwent total arch replacement combined with FET between April 2019 to December 2019. These individuals were divided into the moderate (MO) group (N = 39, surgery performed at moderate hypothermic circulatory arrest) and the mild (MI) group (N = 31, surgery conducted at mild hypothermic circulatory arrest with LBP). Perioperative characteristics were recorded.

RESULTS: No significant difference in any of the pre- and intraoperative variables was observed between the two groups except for circulatory arrest time, which was significantly shorter in the MI group compared with the MO group [10 (8-11) min vs. 35 (31- 34) min, P = 0.000]. After operation, ventilation times [19 (16 - 24) h vs. 24 (17 - 43) h, P = 0.046] and ICU stay [41 (34 - 58) h vs. 54 (42 - 85) h, P = 0.002] were significantly shorter in the MI group compared with the MO group.

CONCLUSIONS: Total arch replacement combined with FET at mild hypothermia circulatory arrest with lower body antegrade perfusion via single upper hemisternotomy approach is safe and feasible with significantly shorter time of circulatory arrest compared with no LBP.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:24

Enthalten in:

The heart surgery forum - 24(2021), 2 vom: 01. Apr., Seite E345-E350

Sprache:

Englisch

Beteiligte Personen:

Jiang, Hui [VerfasserIn]
Liu, Yu [VerfasserIn]
Yang, Zhonglu [VerfasserIn]
Ge, Yuguang [VerfasserIn]
Du, Yejun [VerfasserIn]

Links:

Volltext

Themen:

Journal Article

Anmerkungen:

Date Completed 14.09.2021

Date Revised 07.12.2022

published: Electronic

Citation Status MEDLINE

doi:

10.1532/hsf.3729

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM323535321