Continuous cerebral and myocardial selective perfusion in neonatal aortic arch surgery

Maminirina, Pierre; Pavy, Carine; Bourgoin, Pierre; Baron, Olivier

doi:10.1111/jocs.14930

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…This trial was designed to investigate the potential superiority of MP in terms of shortened posthospital stays before statistical analysis. According to previous studies [ 11 , 15 , 16 ], we calculated that 56 patients per group would be sufficient, with a power of 0.8 and an alpha risk of 0.05. A p value < 0.05 was considered significant.…”

Section: Methodsmentioning

confidence: 99%

Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

Duan,

Zhang,

Chen

et al. 2023

JPM

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The optimal surgical strategy for acute type A aortic dissection (ATAAD) with coronary artery disease (CAD) remains unclear. The goal of this study was to investigate the cardiovascular protective effects of the myocardial priority (MP) strategy or traditional selective cerebral perfusion (SCP) in ATAAD with CAD. A total of 214 adults were analyzed retrospectively, of which 80 underwent the MP strategy intraoperatively. Seventy-nine pairs were propensity-score-matched and divided into SCP and MP groups. The follow-up period ranged from 6 to 36 months. The MP group had a significantly shorter myocardial ischemic time, higher perfusion flow, higher radial artery pressure, and lower incidence of NIRS decrease >20% of the base value, but a longer lower limb circulatory arrest and bypass time than the SCP group. Although similar adverse cardiac and cerebrovascular events were observed in both groups, a shorter posthospital stay, less blood loss and transfusion, higher postoperative hemoglobin, lower creatinine, and higher PaO2/FiO2 were observed in the MP group. Subgroup analysis showed that when the TIMI Risk Score was <4, the MP group had a lower incidence of low cardiac output and lower postoperative cTnI level. The follow-up patients had similar morbidities between the two groups. The novel MP strategy is associated with a shortened myocardial ischemic time, better maintained perfusion of vital organs, and postoperative recovery after surgery for ATAAD combined with non-severe CAD.

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Section: Methodsmentioning

confidence: 99%

Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

Duan,

Zhang,

Chen

et al. 2023

JPM

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“…Among these is the deployment of elective regional perfusion which has been shown to be a promising alternative to DHCA in children undergoing aortic surgery. [4] To date, a comprehensive review of the neurocognitive and developmental index following aortic surgery in neonatal aortic surgeries has yet to be undertaken. In this systematic review, we intend to outline the neurological outcomes and probable risk factors in patients who have undergone aortic surgeries during infancy.…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental Outcomes Following Aortic Surgery in the Paediatric Population

Vivekanandan,

Ndokotsu,

Yubbu

et al. 2023

Preprint

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Introduction: Complex aortic surgeries during infancy may affect the neurodevelopmental of children. The study aimed to outline the neurological outcomes and probable risk factors in patients who had undergone aortic surgeries during infancy. Method: A systematic search of English language articles from Academic Search Complete, Cochrane Database, MEDLINE, ScienceDirect, and Scopus was performed. Studies using tools to assess neurodevelopmental outcomes in the pediatric population who underwent aortic surgery in infancy were reviewed. Studies with non-aortic surgeries and prior neurological comorbidities were excluded. Results: Eight cohort studies and two randomized control trials involving 2776 patients were included. Wechsler Intelligent Scale (WIS) (67%) was the most commonly used tool to measure IQ followed by the Bayley Infant Development scale (BIDS). Two studies reported a lower psychomotor developmental index score in 25% of their cohort. Approximately 32% demonstrated a poor Full Scale Intelligent Quotient of less than 70. Motor dyspraxia was the most commonly reported neurological dysfunction (50%). Low weight at surgery and longer surgical duration affect the neurocognitive process. Conclusions: Complex aortic surgeries and their perioperative course leave significant neurocognitive complications which may be progressive into adulthood. This study suggests that infants undergoing complex aortic surgery would benefit from long-term neurocognitive surveillance to identify emerging complications.

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Growth of unrepaired hypoplastic proximal aortic arch and reintervention rate after aortic coarctation repair

Huuskonen

Hui

Runeckles

et al. 2023

The Journal of Thoracic and Cardiovascular Surgery

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Continuous cerebral and myocardial selective perfusion in neonatal aortic arch surgery

Cited by 4 publications

References 19 publications

Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

Neurodevelopmental Outcomes Following Aortic Surgery in the Paediatric Population

Growth of unrepaired hypoplastic proximal aortic arch and reintervention rate after aortic coarctation repair

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