Application of mild hypothermia arch-clamping technique for DeBakey Ⅰ aortic dissection
10.3760/cma.j.cn112434-20240401-00094
- VernacularTitle:浅低温弓部阻断技术在DeBakey Ⅰ型主动脉夹层修复中的应用
- Author:
Chengnan LI
1
;
Bo JIA
1
;
Yipeng GE
1
;
Yongliang ZHONG
1
;
Hai YU
1
;
Yi YANG
1
;
Zhiyu QIAO
1
;
Haiou HU
1
;
Yongmin LIU
1
;
Junming ZHU
1
Author Information
1. 首都医科大学附属北京安贞医院心血管外科 北京市心肺血管疾病研究所 北京市大血管疾病诊疗研究中心，北京 100029
- Publication Type:Journal Article
- Keywords:
Arch-clamping;
DeBakey Type Ⅰ aortic dissection;
Hypothermic circulatory arrest;
Sun’s procedure
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(3):136-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of mild hypothermia arch-clamping technique in the surgical treatment of DeBakey Type Ⅰ aortic dissection.Methods:From December 2019 to November 2023, a total of 97 patients with DeBakey type Ⅰ aortic dissection who underwent arch-clamping technique in Beijing Anzhen Hospital were prospectively enrolled. The patients were divided into mild hypothermia group and moderate hypothermia group according to the lowest rectal temperature during the circulatory arrest period. The perioperative data of the two groups were compared, and complex adverse outcomes consisting of 30-day death, stroke, paraplegia and CRRT were used as the primary endpoint. Multivariate logistic regression was used to determine the predictors of clinical adverse outcomes. Survival analysis was evaluated by the Kaplan- Meier method. Results:The overall incidence of complex adverse outcomes was 20.6%, 13.6% in the mild hypothermia group and 22.7% in the moderate hypothermia group( P=0.535), and the incidence of stroke was 4.6% and 6.7%( P=1.000), respectively. The cardiopulmonary bypass time and aortic-clamping time in the mild hypothermia group were significantly shortened (147.5 min vs. 163.0 min, P=0.032; 89 min vs. 99 min, P=0.042). There was no significant difference in long-term survival and reintervention between the two groups(91.9% vs. 89.3%, P=0.87; 9.1% vs. 5.3%, P=0.13). Conclusion:Mild hypothermia arch-clamping technique is a safe and effective method for the treatment of DeBakey type Ⅰ aortic dissection, with satisfactory short-term and long-term efficacy.
