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

2021 ◽  
Vol 8 ◽  
Author(s):  
Jian Song ◽  
Jinlin Wu ◽  
Xiaogang Sun ◽  
Xiangyang Qian ◽  
Bo Wei ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Circulatory Arrest ◽  
Early Mortality ◽  
The Body ◽  
Surgical Mortality ◽  
Type A Aortic Dissection ◽  
Multiple Systems ◽  
Factors Affecting ◽  
Single Center Experience ◽  
Baseline Characteristics

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.

The Circulatory Arrest Time in Patients with Acute Type A Aortic Dissection: Does It Influence the Outcome?

2020 ◽  
Author(s):  
J. Kapahnke ◽  
K. Huenges ◽  
M. Salem ◽  
P. Kolat ◽  
J. Schoettler ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Circulatory Arrest ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Preoperative hematological parameters are inadequate for predicting mortality in Stanford Type A aortic dissection repair

2021 ◽  
Vol 5 (2) ◽  
pp. 01-06
Author(s):  
Selim Durmaz ◽  
◽  
Ömer Faruk Rahman ◽  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Roc Analysis ◽  
Circulatory Arrest ◽  
Hematological Parameters ◽  
Demographic Data ◽  
Type A ◽  
Hospital Death ◽  
Acute Type ◽  
Type A Aortic Dissection

Background: Mortality in acute Type A aortic dissection is still high and unpredictable. We aimed to investigate the validity of preoperative hematological markers and possible risk factors in predicting in-hospital mortality in patients operated with deep hypothermic circulatory arrest method. Methods: 78 consecutive patients who were admitted to the emergency service and operated on were retrospectively analyzed. Risk factors for in-hospital death were investigated to develop a predictive model. Results: There was no difference between patients in terms of the were demographic data of the patients. In the mortality group, only preoperative creatinine levels were found to be higher (p < 0.05). Factors affecting mortality were found as total circulatory arrest (TCA) and cross-clamp (X-clamp) times when intraoperative data were examined (p < 0.05). ROC analysis was performed to determine the power to predict mortality and to determine the cut-off point. In ROC analysis to predict mortality, X-Clamp time > 71 minutes, 68.2% sensitivity and 66.1% specificity, TCA > 44.5 minutes, 72.7% sensitivity and 73.2% specificity were found. In the mortality group, these values were found to be significantly higher than those who were discharged. Conclusion: In the surgical treatment of Type A aortic dissection under deep hypothermia, hematologic biomarkers may be insufficient in estimating the risk for mortality. Keywords: Acute; aortic dissection; biomarker; mortality

scholarly journals “Aorta-clamp” technique for surgical repair of acute type A aortic dissection—5 min circulatory arrest at 30 °C

2019 ◽  
Vol 11 (11) ◽  
pp. 4717-4724
Author(s):  
Jie He ◽  
Jihai Peng ◽  
Wei Li ◽  
Dingwen Zheng ◽  
Shihao Cai ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Surgical Repair ◽  
Circulatory Arrest ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Clamp Technique

scholarly journals Deep Hypothermic Circulatory Arrest with Lung Perfusion/Ventilation in a Patient with Acute Type A Aortic Dissection

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Yiliam F. Rodriguez-Blanco ◽  
Lester Garcia ◽  
Tania Brice ◽  
Marco Ricci ◽  
Tomas A. Salerno
Keyword(s):  
Aortic Dissection ◽  
Circulatory Arrest ◽  
Type A ◽  
Deep Hypothermic Circulatory Arrest ◽  
Lung Perfusion ◽  
Hypothermic Circulatory Arrest ◽  
Acute Type ◽  
Perfusion Technique ◽  
Type A Aortic Dissection ◽  
Potential Benefits

A 50-year-old black male presented with acute type A aortic dissection. Surgical repair was performed under deep hypothermic circulatory arrest (DHCA) with lung perfusion/ventilation throughout the procedure. Details of the lung perfusion technique and its potential benefits and drawbacks are discussed.

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