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

Authors

  • Hui Jiang, MD, PhD Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
  • Yu Liu, MD, PhD Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
  • Zhonglu Yang, MD Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
  • Yuguang Ge, MD Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
  • Yejun Du, MD Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China

DOI:

https://doi.org/10.1532/hsf.3729

Keywords:

Minimally invasive cardiac surgery, total arch replacement, lower body perfusion, mild hypothermia circulatory arrest

Abstract

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.

References

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Published

2021-04-01

How to Cite

Jiang, H., liu, yu, Yang, Z., Ge, Y., & Du, Y. (2021). Mild Hypothermic Circulatory Arrest with Lower Body Perfusion for Total Arch Replacement Via Upper Hemisternotomy in Acute Type A Dissection. The Heart Surgery Forum, 24(2), E345-E350. https://doi.org/10.1532/hsf.3729

Issue

Vol. 24 No. 2 (2021)

Section

Articles

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