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Optimal circulatory arrest temperature for total aortic arch replacement: outcomes of neurological complications

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资源类型：
Pubmed体系：
作者：
Xue Yuan[1,2,3] * ; Lou Yeting[1,2,3] * ; Wang Shipan[1,2,3] ; Zhang Yazhe[1,2,3] ; Wang Xiaomeng[1,2,3] ; Zhang Xuehuan[4] ; Shi Yue[5] ; Li Youjin[6] ; Yang Haiping[7] ; Li Hongli[8] ; Liu Gang[9] ; Zhu Minjia[5] ; Huang Jian[10] ; Zhao Qingwu[11] ; Liu Jihong[12] ; Wu Haibo[13] ; Chen Duanduan[4] ; Jiang Wenjian[1,2,3] ; Zhang Hongjia[1,2,3] ; Li Haiyang[1,2,3] ;
机构： [1]Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University, Beijing 100029,China, [2]Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029,China, [3]Beijing Lab for Cardiovascular Precision Medicine, Beijing 100029,China, [4]School of Life Science,Beijing Institute of Technology, Beijing 100081,China, [5]Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China, [6]Department of Cardiac MacrovascularSurgery, People's Hospital of Ningxia Hui Autonomous Region Affiliated to Ningxia Medical University,Yinchuan 750001,Ningxia, China, [7]Department of Cardiac Surgery,Beijing Luhe Hospital,Capital Medical University, Beijing 101100,China, [8]Department of Cardiac Surgery,Xuanwu Hospital of Capital Medical University, Beijing 100071,China, [9]The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China, [10]The First Affiliated Hospital of Xiamen University,the Department of Cardiovascular Surgery,Xiamen 361000, FuJian,China, [11]Department of Cardiothoracic Surgery,Guangdong Provincial Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Guangzhou 510120,Guangdong, China, [12]Department of Cardiovascular Surgery, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001,Liaoning,China, [13]Department of Cardiovascular Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023,Liaoning,China.
出处：
DOI： 10.1016/j.jtcvs.2024.11.034
ISSN：

摘要：
The optimal hypothermic circulatory arrest (HCA) temperature during total arch replacement (TAR) and the impact of HCA temperature on postoperative neurological complications are still uncertain.The aim of this study is to explore the impact of HCA temperature on short-term postoperative outcomes, especially neurological complications, for patients who undergo TAR.We retrospectively analyzed data of 2351 patients who underwent TAR at one of seven selected aortic centers from January 2016 to June 2023. Restricted cubic splines (RCS) and subgroup analyses were performed to determine the relation between temperature and outcomes under different cerebral perfusion methods, cannulation strategies, diagnoses, and surgical timings.The overall in-hospital mortality was 6.2% (n = 146). The incidence of stroke, paraplegia and total-arch composite outcome (TCO) was 6.0% (n = 142), 2.8% (n = 65) and 21.0% (n = 494), respectively. The average HCA temperature was 25.9 ± 1.9 °C, and the median circulatory arrest time was 23 (Q1, Q3: 18, 30) min. Adjusted RCS showed the lowest incidence of stroke, paraplegia, and TCO at temperatures of 26.6 °C, 27.4 °C, and 26.8 °C, but without statistical significance. In subgroup analysis, the unilateral antegrade cerebral perfusion (uACP) group revealed a significant nonlinear relation between HCA temperature and the risk of stroke, and the lowest risk showed at 26.5 °C. Other subgroup analyses did not reveal a significant nonlinear relation between temperature and outcomes.For patients undergoing TAR with uACP, cooling to a temperature of 26-27 °C was associated with the lowest incidence of stroke.Copyright © 2024. Published by Elsevier Inc.

基金：
This study was supported by the Beijing Municipal Science & Technology Commission(No.Z221100007422015),Beijing Hospitals Authority Clinical Medicine Development of special funding support(NO.ZLRL202317),Beijing Natural Science Foundation (NO.7232037 & L232030).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2023]版：
大类 | 1 区 医学
小类 | 1 区 外科 2 区 心脏和心血管系统 2 区 呼吸系统
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 外科 2 区 心脏和心血管系统 2 区 呼吸系统
第一作者：
第一作者机构： [1]Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University, Beijing 100029,China, [2]Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029,China, [3]Beijing Lab for Cardiovascular Precision Medicine, Beijing 100029,China,
共同第一作者：
通讯作者：
通讯机构： [1]Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University, Beijing 100029,China, [2]Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029,China, [3]Beijing Lab for Cardiovascular Precision Medicine, Beijing 100029,China,
推荐引用方式(GB/T 7714)：
Xue Yuan,Lou Yeting,Wang Shipan,et al.Optimal circulatory arrest temperature for total aortic arch replacement: outcomes of neurological complications[J].The Journal Of Thoracic And Cardiovascular Surgery.2024,doi:10.1016/j.jtcvs.2024.11.034.
APA：
Xue Yuan,Lou Yeting,Wang Shipan,Zhang Yazhe,Wang Xiaomeng...&Li Haiyang.(2024).Optimal circulatory arrest temperature for total aortic arch replacement: outcomes of neurological complications.The Journal Of Thoracic And Cardiovascular Surgery,,
MLA：
Xue Yuan,et al."Optimal circulatory arrest temperature for total aortic arch replacement: outcomes of neurological complications".The Journal Of Thoracic And Cardiovascular Surgery .(2024)

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