Optimizing Therapeutic Hypothermia Depths in Acute Type A Aortic Dissection Repair

Existing evidence regarding the impact of hypothermic circulatory arrest (HCA) depth in acute type A aortic dissection (ATAAD) repair lacks robustness concerning blood loss and mortality. We aimed to assess whether using mild and moderate HCA (MMHCA) versus deep and profound HCA (DPHCA) in ATAAD rep...

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Bibliographic Details
Published in:The Journal of surgical research 2024-11, Vol.303, p.636-644
Main Authors: Belyaev, Andrei M., Boldyrev, Sergey Y., Myalyuk, Pavel A., Barbukhatty, Kirill O., Petrishchev, Alexey A., Porkhanov, Vladimir A., Bezdenezhnykh, Oksana S., Marchenko, Andrei V., Trofimov, Nikolay A., Babokin, Vadim E., Smirnova, Daria V.
Format: Article
Language:English
Subjects:
Acute Disease
Acute type A aortic dissection
Adult
Aged
Aortic Dissection - mortality
Aortic Dissection - surgery
Blood loss
Blood Loss, Surgical - prevention & control
Blood Loss, Surgical - statistics & numerical data
Blood transfusion
Circulatory Arrest, Deep Hypothermia Induced - adverse effects
Circulatory Arrest, Deep Hypothermia Induced - methods
Female
Hospital Mortality
Humans
Hypothermia, Induced - methods
Hypothermic circulatory arrest
Long-term survival
Male
Middle Aged
Morbidity
Mortality
Retrospective Studies
Treatment Outcome
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Summary:Existing evidence regarding the impact of hypothermic circulatory arrest (HCA) depth in acute type A aortic dissection (ATAAD) repair lacks robustness concerning blood loss and mortality. We aimed to assess whether using mild and moderate HCA (MMHCA) versus deep and profound HCA (DPHCA) in ATAAD repair is associated with reduced bleeding risk, lower in-hospital mortality, and improved long-term survival. This retrospective cohort study spanned from 2003 to 2023. ATAAD repair patients were identified from hospital records, with exclusion criteria applied to those who died before surgery, those with symptoms lasting longer than 14 d, and those who operated on without HCA. Patients in the DPHCA group underwent surgery with HCA (T ≤ 20°C), while those in the MMHCA group had temperatures ranging from 34°C to 20.1°C. Out of 549 eligible ATAAD patients, the MMHCA group exhibited a reduced rate of chest re-exploration for bleeding (39% versus 14%, P 
ISSN:0022-4804
1095-8673
1095-8673
DOI:10.1016/j.jss.2024.09.023