Lower body perfusion (LBP) is a technique used to provide blood perfusion to
distal organs and spinal cord during circulatory arrest. However, the effect
of LBP on the prognosis of aortic arch surgery, especially on postoperative
renal function, remains unclear.
A total of 304 patients with acute type A aortic dissection who underwent
total aortic arch replacement combined with frozen elephant trunk
implantation between May 2016 and December 2021 were retrospectively
analyzed. The patients were divided into LBP group (group L, n=85) and
non-LBP group (group NL, n=219). Routine lower body circulatory arrest was
applied during operation in group NL, and antegrade LBP combined was applied
during operation in group L. Perioperative data were recorded. Propensity
score matching was used for statistical analysis.
After propensity score matching, 85 pairs of patients were successfully
matched. Two groups significantly differed in circulatory arrest time (six
minutes vs. 30 minutes, P=0.000), cross-clamping time (101 minutes vs. 92
minutes, P=0.010), minimum nasopharyngeal temperature (29.4ºC vs. 27.2ºC,
P=0.000), and highest lactate value during cardiopulmonary bypass (2.3
µmol/L vs. 4.1 µmol/L, P=0.000). Considering the postoperative
indicators, the drainage volume (450 mL vs. 775 mL, P=0.000) and the
incidence of level I acute kidney injury (23.5% vs. 32%, P=0.046) in group L
was lower than those in group NL.
LBP resulted as a safe and feasible approach in aortic arch surgery, as it
could significantly shorten the circulatory arrest time, which might reduce
the incidence of postoperative level I acute kidney injury.