Total arch replacement using a 4‐branched vascular graft without circulatory arrest

Long, Chaozhong; Feng, Yao-guang; He, Dongyi; Wang, Yuanxing; Lyv, Xiaolin; Kuang, Wenan

doi:10.1111/jocs.14043

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…The conventional Sun's surgical method uses unilateral cerebral perfusion by CPB to maintain the perfusion of the brain, and the reconstruction of arch branches must be performed under CPB 4 . Although the other arch-first technique before us ensured the cerebral perfusion or reduced time, they were still performed under CPB [8][9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

Simplified Arch-first Technique in Aortic Arch Branches Replacement: Perfusion without Cardiopulmonary Bypass

Wang

Song

Wang

et al. 2022

Preprint

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Introduction：Surgery is the mainstay of treatment for aortic dissection which lesion affected the aortic arch. Conventional surgical methods usually use unilateral cerebral perfusion by cardiopulmonary bypass (CPB) to maintain the perfusion of the brain, and the reconstruction of arch branches must be performed under CPB. Unilateral cerebral perfusion with prolonged CPB may lead to complications of cerebral hypoperfusion. We propose a new technique that can accomplish aortic arch branches replacement without the use of cardiopulmonary bypass and maintain bilateral cerebral perfusion at all times. Materials and Methods: From January 2018 to July 2021, we performed the new technique in 23 patients. Furthermore, we performed a retrospective analysis with patients undergoing conventional surgery during the same period, comparing perioperative data and follow-up data between two groups. Result: The CPB time, deep hypothermic circulatory arrest time and aortic cross-clamping time of new technique group was significantly shorter than conventional group. Other perioperative data and follow-up data were not statistically different. Discussion: Simplified arch-first technique can significantly shorten CPB, aortic cross-clamping and deep hypothermic circulatory arrest time. The technique is theoretically safer because it can better protect the cerebral perfusion during the operation. The short-term efficacy of this technique is the same as that of conventional surgery, and it is more convenient for surgeons to operate. Conclusions: Compared with the conventional method, the simplified arch-first technique is non-inferior, friendly in operation and safer in theory, and is worthy of promotion. Key words: Aortic dissection; Arch-first; Cardiopulmonary bypass; Aortic arch reconstruction

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Section: Discussionmentioning

confidence: 99%

Simplified Arch-first Technique in Aortic Arch Branches Replacement: Perfusion without Cardiopulmonary Bypass

Wang

Song

Wang

et al. 2022

Preprint

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Postoperative imaging of thoracic aortic repairs

et al. 2023

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Banking Fragility and Distress: An Econometric Study of Macroeconomic Determinants

Pesola

2005

SSRN Journal

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The macroeconomic determinants of banking sector distresses in the Nordic countries, Belgium, Germany, Greece, Spain and the UK are analysed using an econometric model estimated on panel data from partly the early 1980s to 2002. The dependent variable is the ratio of banks' loan losses to lending. In addition to the lagged dependent variable, the explanatory variables include a surprise change in incomes and real interest rates, both variables as a separate cross-product term with lagged aggregate indebtedness. The underlying macroeconomic account that this paper puts forward is that loan losses are basically generated by strong adverse aggregate shocks under high exposure of banks to such shocks. The underlying innovations to income and real interest rates are constructed using published macro-economic forecast for these variables.According to the results, high customer indebtedness combined with adverse macroeconomic surprise shocks to income and real interest rates contributed to the distress in banking sector. Loan losses also display strong autoregressive behaviour which might indicate a feedback effect from loan losses back to macroeconomic level in deep recessions. The results can be used in macro stresstesting the banking sector.

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Total arch replacement using a 4‐branched vascular graft without circulatory arrest

Cited by 3 publications

References 6 publications

Simplified Arch-first Technique in Aortic Arch Branches Replacement: Perfusion without Cardiopulmonary Bypass

Simplified Arch-first Technique in Aortic Arch Branches Replacement: Perfusion without Cardiopulmonary Bypass

Postoperative imaging of thoracic aortic repairs

Banking Fragility and Distress: An Econometric Study of Macroeconomic Determinants

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