"Brain-First" Total Body Retrograde Perfusion and Retrograde Cerebral Perfusion in Hemi-Arch Replacement

Authors

  • Zhen Qin Department of Anesthesiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
  • Yannan Zhou West China School of Medicine, Sichuan University, 610065 Chengdu, Sichuan, China
  • Bo Wang Department of Anesthesiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
  • Haohan Chen West China School of Medicine, Sichuan University, 610065 Chengdu, Sichuan, China
  • Jiyue Xiong Department of Anesthesiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
  • Jun Gu Department of Cardiovascular Surgery, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China

DOI:

https://doi.org/10.59958/hsf.7447

Keywords:

brain-first total body retrograde perfusion, hemi-arch replacement, moderate hypothermia circulatory arrest, retrograde cerebral perfusion

Abstract

Objective: The purpose of this study is to compare the early outcomes of brain-first total body retrograde perfusion (Bf-TBRP) in comparison with retrograde cerebral perfusion (RCP) under moderate hypothermia circulatory arrest (MHCA) for hemi-arch replacement surgery. Methods: We analyzed the data of 88 patients who underwent hemi-arch replacement with Bf-TBRP (n = 18) or RCP (n = 70) under MHCA at West China Hospital of Sichuan University between 1 January 2020, and 31 July 2022. In-hospital mortality, neurological deficits, and other adverse events were recorded, which were evaluated with logistic regression to determine risk factors. Results: There was no significant difference between the Bf-TBRP and RCP groups in in-hospital mortality, cardiac events, neurological deficits, dialysis, gastrointestinal complications, and paralysis (p > 0.05). The Bf-TBRP group was associated with significantly shorter hospital stay [Bf-TBRP: 8 d (interquartile range (IQR), 7–10) vs. RCP: 10 d (IQR, 8–13), p = 0.03] and fewer platelet transfusions [Bf-TBRP: 1.0 (IQR, 0–1.0) vs. RCP: 1.0 (IQR, 1.0–2.0), p = 0.05] than the RCP group. On multivariable logistic regression analysis, emergency surgery (p = 0.05) and surgery duration (p = 0.03) were determined to be risk factors. Conclusions: The study showed that Bf-TBRP is a safe technique for patients undergoing hemi-arch replacement with MHCA.

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Published

2024-05-16

How to Cite

Qin, Z., Zhou, Y., Wang, B., Chen, H., Xiong, J., & Gu, J. (2024). "Brain-First" Total Body Retrograde Perfusion and Retrograde Cerebral Perfusion in Hemi-Arch Replacement. The Heart Surgery Forum, 27(5), E511-E519. https://doi.org/10.59958/hsf.7447

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