Hemiarch replacement at 28°C: an analysis of mild and moderate hypothermia in 500 patients

The Annals of Thoracic Surgery
Bradley G LeshnowerEdward P Chen

Abstract

During the past decade, use has increased of moderate hypothermic circulatory arrest with antegrade cerebral perfusion for cerebral protection during aortic arch operations. This study examined the use of mild hypothermia in conjunction with unilateral selective antegrade cerebral perfusion (uSACP) for hemiarch replacement for proximal aortic arch reconstruction. A retrospective review of the Emory Aortic Database identified 708 patients who underwent aortic arch replacement between 2004 and 2011. Of these, 500 underwent hemiarch replacement at temperatures of 22°C or higher with uSACP. Outcomes were analyzed and compared between 277 patients undergoing hemiarch at a temperature of 28.6°C (mild) and 233 undergoing hemiarch at a temperature of 24.3°C (moderate). Propensity scores were generated and analyzed between the groups to adjust for confounding factors such as selection bias. Operative mortality was equivalent between mild and moderate groups in elective (4.2% vs 4.8%, p=0.80) and emergency (7.7% vs 11.7%, p=0.43) settings. No differences occurred in the incidence of temporary neurologic dysfunction, dialysis-dependent renal failure, or mediastinal reexploration for bleeding between mild and moderate patients. The inciden...Continue Reading

References

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Citations

Feb 14, 2013·General Thoracic and Cardiovascular Surgery·Ikuo FukudaWakako Fukuda
Jul 6, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marek Ehrlich
Oct 3, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Yanmin YangJian Ye
May 1, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Maximilian LuehrChristian D Etz
Jan 1, 2016·Therapeutic Hypothermia and Temperature Management·Daniele LinardiAlessio Rungatscher
Mar 19, 2014·The Journal of Thoracic and Cardiovascular Surgery·Bradley G LeshnowerEdward P Chen
Nov 5, 2013·The Annals of Thoracic Surgery·Christina M VassilevaStephen R Hazelrigg
Apr 9, 2013·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Stephen M LangleyRabin Gerrah
Sep 14, 2015·The Annals of Thoracic Surgery·Konstantinos PerreasAndreas Bairaktaris
Jan 19, 2016·The Annals of Thoracic Surgery·Ravi K Ghanta
Aug 4, 2015·The Annals of Thoracic Surgery·Bradley G LeshnowerEdward P Chen
Feb 27, 2014·The Journal of Thoracic and Cardiovascular Surgery·Khaled D AlgarniTerrence M Yau
Dec 17, 2014·Therapeutic Hypothermia and Temperature Management·Xue-Han NingMichael A Portman
Oct 21, 2016·General Thoracic and Cardiovascular Surgery·Michael O Kayatta, Edward P Chen
Aug 12, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Jacob T GutscheJohn G T Augoustides
Jan 22, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sven PeterssChristian Hagl
May 31, 2014·Seminars in Cardiothoracic and Vascular Anesthesia·Heather ReedGregory M Janelle
Oct 22, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Ramesh SinghT Brett Reece
Nov 9, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Edward P Chen, Bradley Graham Leshnower
Oct 22, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Jeffrey E KeenanG Chad Hughes
Nov 18, 2017·General Thoracic and Cardiovascular Surgery·Amer HarkyGiovanni Mariscalco
Apr 16, 2014·Circulation·Tristan D YanUNKNOWN International Aortic Arch Surgery Study Group
Jan 5, 2018·General Thoracic and Cardiovascular Surgery·Amer HarkyAnthony L Estrera
Dec 30, 2015·BioMed Research International·Andreas HabertheuerPrashanth Vallabhajosyula
Jan 23, 2019·The Journal of Thoracic and Cardiovascular Surgery·Amine MazineUNKNOWN Canadian Thoracic Aortic Collaborative Investigators
Jan 13, 2021·Interactive Cardiovascular and Thoracic Surgery·Habib JabagiMunir Boodhwani
Nov 27, 2020·Seminars in Thoracic and Cardiovascular Surgery·Shenghua LiangXiaogang Sun

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