Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Association Between Duration of Deep Hypothermic Circulatory Arrest and Surgical Outcome in Patients with Acute Type A Aortic Dissection: A Large Retrospective Cohort Study

Mona Salehi Ravesh
* ORCID logo ,
Christine Friedrich
,
Jan Schoettler
,
Lars Hummitzsch
,
Gunnar Elke
ORCID logo ,
Mohamed Salem
ORCID logo ,
Georg Lutter
ORCID logo ,
Thomas Puehler
ORCID logo ,
Jochen Cremer
,
Assad Haneya
Version 1 : Received: 17 January 2022 / Approved: 21 January 2022 / Online: 21 January 2022 (13:12:22 CET)

A peer-reviewed article of this Preprint also exists.

Salehi Ravesh, M.; Friedrich, C.; Schoettler, J.; Hummitzsch, L.; Elke, G.; Salem, M.; Lutter, G.; Puehler, T.; Cremer, J.; Haneya, A. Association between Duration of Deep Hypothermic Circulatory Arrest and Surgical Outcome in Patients with Acute Type A Aortic Dissection: A Large Retrospective Cohort Study. J. Clin. Med. 2022, 11, 644. Salehi Ravesh, M.; Friedrich, C.; Schoettler, J.; Hummitzsch, L.; Elke, G.; Salem, M.; Lutter, G.; Puehler, T.; Cremer, J.; Haneya, A. Association between Duration of Deep Hypothermic Circulatory Arrest and Surgical Outcome in Patients with Acute Type A Aortic Dissection: A Large Retrospective Cohort Study. J. Clin. Med. 2022, 11, 644.

Abstract

(1) Background: Deep hypothermic circulatory arrest (DHCA) with selective antegrade cerebral perfusion (ACP) is an established cerebral protection technique for the conduction of complex surgical procedures involving the aortic arch. It is controversial if the duration of DHCA is associated with adverse outcome in patients with acute type A aortic dissection (AAAD). Our goal was to investigate whether DHCA time was associated with surgical outcome in patients undergoing a surgical treatment of AAAD. (2) Methods: 410 Patients were divided into two groups concerning the DHCA time less than 60 minutes and equal or longer than 60 minutes. (3) Results: Patients with longer DHCA time were significantly younger (p=0.001). Intraoperatively, complex procedures with aortic arch surgery were more common in patients with longer DHCA time (p<0.001). Accordingly, cardiopulmonary bypass (p<0.001), cross-clamping (p<0.001) and DHCA times (p<0.001) were significantly longer in this group. Postoperatively, only the duration of mechanical ventilation (p<0.001) and the rate of tracheotomy were significantly higher in these patients. 30-day mortality was satisfactory for both groups (p=0.746). (4) Conclusions: Our results showed that improvements in perioperative management including ACP allow a successful performance of surgical treatment of AAAD under DHCA with duration of even longer than 60 minutes.

Keywords

Deep hypothermic circulatory arrest time; acute type A aortic dissection; surgical outcome

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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