TY - JOUR AU - Jiang, Hui AU - liu, yu AU - Yang, Zhonglu AU - Ge, Yuguang AU - Du, Yejun PY - 2021/04/01 Y2 - 2024/03/28 TI - Mild Hypothermic Circulatory Arrest with Lower Body Perfusion for Total Arch Replacement Via Upper Hemisternotomy in Acute Type A Dissection JF - The Heart Surgery Forum JA - HSF VL - 24 IS - 2 SE - DO - 10.1532/hsf.3729 UR - https://journal.hsforum.com/index.php/HSF/article/view/3729 SP - E345-E350 AB - <p class="p1"><span class="s1"><strong>Background</strong>: 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.</span></p><p class="p1"><span class="s1"><strong>Methods</strong>: 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 (<em>N</em> = 39, surgery performed at moderate hypothermic circulatory arrest) and the mild (MI) group (<em>N</em> = 31, surgery conducted at mild hypothermic circulatory arrest with LBP). Perioperative characteristics were recorded.</span></p><p class="p1"><span class="s1"><strong>Results</strong>: 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, <em>P</em> = 0.000]. After operation, ventilation times [19 (16 - 24) h vs. 24 (17 - 43) h, <em>P</em> = 0.046] and ICU stay [41 (34 - 58) h vs. 54 (42 - 85) h, <em>P</em> = 0.002] were significantly shorter in the MI group compared with the MO group.</span></p><p class="p1"><span class="s1"><strong>Conclusions</strong>: 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.</span></p> ER -