Int J Angiol 2018; 27(04): 190-195
DOI: 10.1055/s-0038-1675204
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Moderate Hypothermia and Antegrade Cerebral Perfusion during Repair of Type A Aortic Dissection

Sotiris C. Stamou
1   Department of Cardiovascular Surgery, JFK Medical Center, Atlantis, Florida
,
Michael A. McHugh
2   University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, Iowa
,
Brian D. Conway
2   University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, Iowa
,
Marcos Nores
1   Department of Cardiovascular Surgery, JFK Medical Center, Atlantis, Florida
› Author Affiliations
Funding None.
Further Information

Publication History

Publication Date:
29 October 2018 (online)

Abstract

The goal of this study was to compare early postoperative outcomes and actuarial survival between patients who underwent repair of acute type A aortic dissection with deep or moderate hypothermia.

A total of 132 consecutive patients from a single academic medical center underwent repair of acute type A aortic dissection between January 2000 and June 2014. Of those, 105 patients were repaired under deep hypothermia (< 24 C°), while 27 patients were repaired under moderate hypothermia (≥24 C°). Median ages were 62 years (range: 27–86) and 59 years (range: 35–83) for patients repaired under deep hypothermia compared with patients repaired under moderate hypothermia, respectively (p = 0.451). Major morbidity, operative mortality, and 10-year actuarial survival were compared between groups.

Operative mortality was 17.1 and 7.4% in the deep and moderate hypothermia groups, respectively (p = 0.208). Incidence of permanent stroke was 12.4% in the deep hypothermic circulatory arrest group and 0% in the moderate hypothermia group (p = 0.054). Actuarial 5- and 10-year survival demonstrated a trend for lower long-term mortality with moderate hypothermia compared with deep hypothermia (69% 5-year and 54% 10-year for deep hypothermia vs. 79% 5-year and 10-year for moderate hypothermia, log-rank p = 0.161).

Moderate hypothermia is a safe and efficient alternative to deep hypothermia and may have protective benefits. Stroke rate was lower with moderate hypothermia.

 
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