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It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience

Objective: The duration of hypothermic circulatory arrest (HCA) is one of the important factors affecting the prognosis of arch surgery, which is still controversial. The purpose of this study was to investigate the effect of HCA duration on early prognosis in type A aortic dissection (TAAD) patient...

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Autores principales: Song, Jian, Wu, Jinlin, Sun, Xiaogang, Qian, Xiangyang, Wei, Bo, Wang, Wei, Wang, De, Qiu, Jiawei, Cao, Fangfang, Gao, Wei, Zhao, Rui, Dai, Lu, Fan, Shuya, Xie, Enzehua, Qiu, Juntao, Luo, Xinjin, Yu, Cuntao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702722/
https://www.ncbi.nlm.nih.gov/pubmed/34957256
http://dx.doi.org/10.3389/fcvm.2021.773268
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author Song, Jian
Wu, Jinlin
Sun, Xiaogang
Qian, Xiangyang
Wei, Bo
Wang, Wei
Wang, De
Qiu, Jiawei
Cao, Fangfang
Gao, Wei
Zhao, Rui
Dai, Lu
Fan, Shuya
Xie, Enzehua
Qiu, Juntao
Luo, Xinjin
Yu, Cuntao
author_facet Song, Jian
Wu, Jinlin
Sun, Xiaogang
Qian, Xiangyang
Wei, Bo
Wang, Wei
Wang, De
Qiu, Jiawei
Cao, Fangfang
Gao, Wei
Zhao, Rui
Dai, Lu
Fan, Shuya
Xie, Enzehua
Qiu, Juntao
Luo, Xinjin
Yu, Cuntao
author_sort Song, Jian
collection PubMed
description Objective: The duration of hypothermic circulatory arrest (HCA) is one of the important factors affecting the prognosis of arch surgery, which is still controversial. The purpose of this study was to investigate the effect of HCA duration on early prognosis in type A aortic dissection (TAAD) patients who underwent arch surgery in our center. Methods: All consecutive patients who underwent surgical treatment for TAAD in Fuwai Hospital from January 2013 to December 2018 were included in this study and divided into four quartile groups based on HCA time. Baseline characteristics, perioperative indicators, and early mortality were statistically analyzed by propensity score matching (PSM) and restricted cubic spline (RCS) method. Perioperative adverse events were confirmed according to the American STS database and Penn classification. Results: About 1,018 consecutive patients (mean age 49.11 ± 1.4 years, male 74.7%) with TAAD treated surgically were eventually included in this study. After PSM, with the prolongation of HCA time, the surgical mortality rates of group [2,15], (15,18], (18,22], and (22,73] were 4.1, 6.6, 7.8, and 10.9% with p = 0.041, respectively. As shown in RCS, the mortality rate increased sharply after the HCA time exceeded 22 min. And from the subgroup analysis, the HCA time of 22 min or less was associated with better clinical outcomes (OR 2.09, 95%CI 1.25–3.45, p = 0.004). Conclusions: The early mortality increases significantly with the duration of HCA time when arch surgery was performed. And multiple systems throughout the body can be adversely affected.
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spelling pubmed-87027222021-12-25 It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience Song, Jian Wu, Jinlin Sun, Xiaogang Qian, Xiangyang Wei, Bo Wang, Wei Wang, De Qiu, Jiawei Cao, Fangfang Gao, Wei Zhao, Rui Dai, Lu Fan, Shuya Xie, Enzehua Qiu, Juntao Luo, Xinjin Yu, Cuntao Front Cardiovasc Med Cardiovascular Medicine Objective: The duration of hypothermic circulatory arrest (HCA) is one of the important factors affecting the prognosis of arch surgery, which is still controversial. The purpose of this study was to investigate the effect of HCA duration on early prognosis in type A aortic dissection (TAAD) patients who underwent arch surgery in our center. Methods: All consecutive patients who underwent surgical treatment for TAAD in Fuwai Hospital from January 2013 to December 2018 were included in this study and divided into four quartile groups based on HCA time. Baseline characteristics, perioperative indicators, and early mortality were statistically analyzed by propensity score matching (PSM) and restricted cubic spline (RCS) method. Perioperative adverse events were confirmed according to the American STS database and Penn classification. Results: About 1,018 consecutive patients (mean age 49.11 ± 1.4 years, male 74.7%) with TAAD treated surgically were eventually included in this study. After PSM, with the prolongation of HCA time, the surgical mortality rates of group [2,15], (15,18], (18,22], and (22,73] were 4.1, 6.6, 7.8, and 10.9% with p = 0.041, respectively. As shown in RCS, the mortality rate increased sharply after the HCA time exceeded 22 min. And from the subgroup analysis, the HCA time of 22 min or less was associated with better clinical outcomes (OR 2.09, 95%CI 1.25–3.45, p = 0.004). Conclusions: The early mortality increases significantly with the duration of HCA time when arch surgery was performed. And multiple systems throughout the body can be adversely affected. Frontiers Media S.A. 2021-12-10 /pmc/articles/PMC8702722/ /pubmed/34957256 http://dx.doi.org/10.3389/fcvm.2021.773268 Text en Copyright © 2021 Song, Wu, Sun, Qian, Wei, Wang, Wang, Qiu, Cao, Gao, Zhao, Dai, Fan, Xie, Qiu, Luo and Yu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Song, Jian
Wu, Jinlin
Sun, Xiaogang
Qian, Xiangyang
Wei, Bo
Wang, Wei
Wang, De
Qiu, Jiawei
Cao, Fangfang
Gao, Wei
Zhao, Rui
Dai, Lu
Fan, Shuya
Xie, Enzehua
Qiu, Juntao
Luo, Xinjin
Yu, Cuntao
It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
title It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
title_full It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
title_fullStr It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
title_full_unstemmed It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
title_short It Is Advisable to Control the Duration of Hypothermia Circulatory Arrest During Aortic Dissection Surgery: Single-Center Experience
title_sort it is advisable to control the duration of hypothermia circulatory arrest during aortic dissection surgery: single-center experience
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702722/
https://www.ncbi.nlm.nih.gov/pubmed/34957256
http://dx.doi.org/10.3389/fcvm.2021.773268
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