The strategy of cardiopulmonary bypass for total aortic arch replacement and the frozen elephant trunk technique with aortic balloon occlusion

Li, Yunfeng; Yan, Shujie; Lou, Song; Sun, Xiaogang

doi:10.1177/0300060520905410

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…Lower body perfusion (LBP) is a technique used for the provision of blood perfusion to distal organs and spinal cord during traditional circulatory arrest. This approach can solve the problem of intraoperative distal organ ischemia and significantly shorten the circulatory arrest time, thus making it possible to raise the temperature during circulatory arrest in aortic arch surgery [ 3 ] . Our previous studies found that applying antegrade LBP can significantly shorten the circulatory arrest time to 10 (8,11) minutes, thus significantly shortening the ischemia and hypoxia time of visceral organs and spinal cord [ 4 ] .…”

Section: Introductionmentioning

confidence: 99%

Lower Body Perfusion Reduces the Morbidity of Postoperative Acute Kidney Injury in Type A Dissection: A Propensity-Matched Analysis

Tang¹,

Liu²,

Wang³

et al. 2023

Braz J Cardiovasc Surg

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Introduction 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. Methods 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. Results 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. Conclusion 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.

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Section: Introductionmentioning

confidence: 99%

Lower Body Perfusion Reduces the Morbidity of Postoperative Acute Kidney Injury in Type A Dissection: A Propensity-Matched Analysis

Tang¹,

Liu²,

Wang³

et al. 2023

Braz J Cardiovasc Surg

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Efficiency and Safety of Temperatures Management in Aortic Arch Surgery: A System Review and Meta-Analysis

Yu,

Ding,

Shi

et al. 2023

Journal of Cardiac Surgery

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Objective. The study evaluates the safety and efficacy of hypothermic cardiac arrest (HCA) at various temperatures in aortic arch surgeries. Methods. We conducted a literature search in PubMed, Google Scholar, and Embase databases. For single proportion assessments, we employed fixed-effect and random-effect models in the general linear mixture model and the inverse variance model for other computations. We analyzed factors such as age, sex, operation time, and postoperative complications, with subgroup and metaregression analyses. We used funnel plots to depict potential publication bias. Results. Our research incorporated 43 papers with 34,797 cases. HCA temperatures were divided into five groups (A: 30–32°C, B: 28–30°C, C: 26–28°C, D: 24–26°C, and E: <24°C). There is no statistically significant difference in myocardial ischemia time ( P = 0.90) and isolated cerebral perfusion (ICP) time ( P = 0.95). Groups A and C have the best performance in avoiding postoperative complications including transient nerve injury (TNI), permanent nerve injury (PNI), renal failure (RF), and mortality occurrence rate. Group A has the lowest occurrence rate in PNI (3%) and mortality (3%). Group C has the lowest RF incidence (5%). Conclusion. Maintaining temperatures of 30–32°C in en bloc anastomosis or 26–28°C during arch replacement with separate grafts can significantly reduce complications including PNI, RF, and in-hospital mortality.

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Mortality and neurologic complications after repair of aortic arch pathology with elephant trunk procedures: a systematic review with meta-analysis

FERREIRA¹,

Oliveira‐Pinto²,

Mansilha³

2022

Int Angiol

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The strategy of cardiopulmonary bypass for total aortic arch replacement and the frozen elephant trunk technique with aortic balloon occlusion

Cited by 3 publications

References 28 publications

Lower Body Perfusion Reduces the Morbidity of Postoperative Acute Kidney Injury in Type A Dissection: A Propensity-Matched Analysis

Lower Body Perfusion Reduces the Morbidity of Postoperative Acute Kidney Injury in Type A Dissection: A Propensity-Matched Analysis

Efficiency and Safety of Temperatures Management in Aortic Arch Surgery: A System Review and Meta-Analysis

Mortality and neurologic complications after repair of aortic arch pathology with elephant trunk procedures: a systematic review with meta-analysis

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