Meta-analysis of the effects of anterograde and retrograde cerebral perfusion in aortic arch surgery
10.3760/cma.j.issn.1001-4497.2019.09.010
- VernacularTitle: 主动脉弓部手术中顺行和逆行脑灌注脑保护疗效比较meta分析
- Author:
Zulei ZHANG
1
;
Wei YANG
2
;
Yi GONG
2
;
Miaomiao YOU
1
;
Weichang XU
1
;
Chao LU
1
;
Xiao DONG
2
Author Information
1. Department of Medicine, Nanchang University, Nanchang 330006, China
2. Department of Cardiovascular Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Publication Type:Journal Article
- Keywords:
Aortic arch surgery Antegrade cerebral perfusion Retrograde cerebral perfusion Brain protection
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(9):546-550
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the differences in brain protection between anterograde cerebral perfusion(ACP) and retrograde cerebral perfusion(RCP) in aortic arch surgery.
Methods:Aortic arch circulatory surgery, ACP and RCP techniques were searched at the Cochrane Library, PubMed, EMBASE, Wanfang Database and the Chinese Biomedical Database from January 2013 to December 2018. Cohort studies were then performed with early postoperative death, transient neurological dysfunction(TND), stroke, and transient ischemic attack(TIA). For each study, data on endpoints in the ACP and RCP groups were used to generate risk ratios(RR) and 95% confidence intervals(CI). The funnel chart was used to test publication bias.
Results:A total of 6 692 patients were enrolled in 12 studies, of which 3 902 patients received low-temperature circulatory arrest plus ACP, and 2 790 patients received low-temperature circulatory arrest plus RCP. Summary analysis showed that the early postoperative death(RR=0.83, 95%CI=0.51-1.35, P=0.46), stroke(RR=1.09, 95%CI=0.91-1.31, P=0.33), transient neurological dysfunction(RR=0.81, 95%CI=0.17-3.91, P=0.80) and transient ischemic attack(RR=1.00, 95%CI=0.74-1.34, P=1.00) in both groups were no significant differences(all P>0.05).
Conclusion:There are no significant differences in postoperative mortality and neurological dysfunction between antegrade cerebral perfusion and retrograde cerebral perfusion in the aortic arch surgery. Combined with hypothermic circulatory arrest, it can be selected according to the actual situation of aortic arch surgery.
