Patient population
Each site’s institutional review board has approved this study. Because
of its retrospective nature, the local ethics committees waived the need
for specific patient consent.
This is a retrospective cohort observational multicentric study that
utilizes data from 7 institutional databases of patients who underwent
elective aortic arch surgery under circulatory arrest (CA), from 2018
till 2021.
Patients with acute aortic syndrome or with chronic aortic dissections
were excluded. Two-hundred-fifty patients were included and stratified
according to the adjunctive CP techniques used, if any. Forty cases were
excluded because of missing data (n=11) or techniques not included in
the analysis (n=26). Three more cases, defined as “outliers”, were
excluded as well. Finally, the cases included in the analysis were 210.
Patients were then divided in two groups according to the surgical
strategy. The first group (n=59) included patients operated on during
DHCA at ≤ 20°C, without any CP, and DR (DHCA+DR group). Cerebral and
lower body CA coincided. The second group (n=151) included patients
operated on during MHCA, median temperature 26°C, and ACP (MHCA+ACP
group). The brain was continuously perfused and the duration of CA
involved only the lower body.