Acta Clinica Croatica (Jan 2022)
Unilateral Antegrade Cerebral Perfusion versus Deep Hypothermic Circulatory Arrest during Acute Aortic Dissection Repair: A Single Center Experience
Abstract
Introduction: The gold standard of circulation strategy and arterial cannulation during acute aortic dissection is still indisputable. Unilateral/bilateral antegrade cerebral perfusion (UACP/BACP) and deep hypothermic circulatory arrest (HCA) remains a safe and useful procedure for circulation during management of acute aortic dissection. The aim of our study was to investigate the effectiveness of both unilateral antegrade cerebral perfusion and deep hypothermic circulatory arrest on postoperative outcomes during management of acute aortic dissection repair at our center. Methods: Our prospective study consisted of 26 patients who underwent acute aortic dissection repair with various circulation strategy. Group A consisted of 14 (53.8%) patients who were operated on under unilateral antegrade cerebral perfusion, while group B consisted of 12 (46.2%) patients who were operated on under deep hypothermic circulatory arrest without cerebral perfusion. Postoperative outcomes included mortality, drainage, blood transfusion (free frozen plasma, erythrocyte suspension), ventilation time and revision due to bleeding. Results: The average age of our study population was 55.2 ± 16.2 (range 33-83) years. Mortality was observed in 3 (11.5 %) of our patients. There was no significant difference between the groups in terms of mortality and revision due to bleeding (p ˃ 0.05). Blood transfusion (erythrocyte suspension and free frozen plasma), drainage and ventilation time were significantly lower in Group A compared with Group B (p ˃ 0.05). Conclusion: Both unilateral antegrade cerebral circulation and deep hypothermic circulatory arrest can be safely used during acute aortic dissection, although unilateral antegrade cerebral circulation has proved to be superior over deep hypothermic circulatory arrest with good postoperative outcomes.
