Moderate and Deep Hypothermic Circulatory Arrest Have Comparable Effects on Severe Systemic Inflammatory Response Syndrome After Total Aortic Arch Replacement in Patients With Type A Aortic Dissection

• DOI: 10.3389/fsurg.2021.758854
• Publication Date: 2021-12-06T04:48:13Z
• Authors: Yingjie Du; Zhongrong Fang; Yanhua Sun; Congya Zhang; Guiyu Lei; Yimeng Chen; Lijing Yang; Xiying Yang; Jun Li; Guyan Wang
• Keywords: Elephant trunks

Background: The objective of this study was to compare the incidence severe systemic inflammatory response syndrome (sSIRS) after total aortic arch replacement between patients who underwent moderate hypothermic circulatory arrest (MHCA) and those deep (DHCA). Methods: At Fuwai Hospital, 600 with MHCA or DHCA from January 2013 December 2016 were consecutively enrolled divided into (14.1-20.0°C) (20.1-28.0°C) groups. Preliminary statistical analysis revealed that some baseline indicators differed two groups; therefore, propensity score matching (PSM) used balance covariates. Post-operative sSIRS as primary outcome compared groups both before PSM. Results: A 275 (45.8%) MHCA, 325 (54.2%) DHCA. After PSM analysis, a 191 matched pairs obtained. overall 27.3%. There no significant difference in post-operative group either cohort (no-PSM: P = 0.188; PSM: 0.416); however, increased by ~4% no-PSM cohorts 29.5 vs. 24.7%; 29.3 25.1%). Both PSM, rates gastrointestinal hemorrhage pulmonary infection length stay significantly (P < 0.05), remaining secondary outcomes not different Conclusions: are associated comparable incidences following for type dissection. However, had shorter cardiopulmonary bypass time, lower than group. We cautiously recommend use most replacements