The Application Of Moderate Hypothermic Anterograde Cerebral Perfusion In The Protection Of Central Nervous System During Aortic Arch Surgery

Objective:To discuss whether moderate hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion is better than profound hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion in the cerebral protection during aortic arch surgery.Methods:Retrospective analysis was made to the 103 patients diagnosed with Stanford type A aortic dissection in the First Hospital of Jilin University from January 2010 to December 2016,and the right subclavian artery and right atrium were performed in all patients.According to the nasopharyngeal temperature during the period of circulatory arrest,the patients were divided into profound hypothermia group(group PH;T=19.80�1.74?)and moderate hypothermia group(group MH;T=26.54�1.71?).There were 45 cases in group PH(43.7%)and 58 cases in group MH(56.3%).Results:There were significant differences between the two groups in the hypertension(P=0.03),cardiopulmonary bypass time(P=0.001),the assist circulation time(P=0.001),the temperature of circulatory arrest(P<0.001),mechanical ventilation time(P=0.014)and central nervous system damage after the operation(P=0.031).But there were not significant differences between the two groups in the mortality(37.8% versus 29.3%;P=0.365)and severe postoperative adverse events(P=0.582).Conclusion:Although there is no significant difference between the two methods in reducing mortality,but during the period of circulatory arrest,moderate hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion is superior to profound hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion in the cerebral protection during aortic arch surgery and it is a safer and more effective cerebral protecting method.