Neuroprotective Effect Of Arrested Circulation At Different Temperature For Treating Stanford A Aortic Dissection With A Three-branch Blood Vessel Scaffold

Objective: Observe the cerebral protection effect of circulatory arrest on treatment by tri-branch intravascular stent on Stanford A aortic dissection under different temperatures..Methods:Conduct retrospective analysis on 76 patients of Stanford A aortic dissection in our hospital, and the surgical procedures are “ascending aorta replacement+ vascular remodeling of arcus aortae and descending part by tri-branch intravascular stent”, and “bilateral antegrade cerebral perfusion” is adopted. Divide the experimental groups into two groups based on temperatures of circulatory arrest(rectal temperature), Group A and B, of which the temperature of circulatory arrest is respectively 20℃ and 25℃. Compare thefollowing factors of the two groups, extracorporeal circulation time, cooling time, cardiac muscle blocking time, low-discharge cerebral perfusion time, time of circulatory arrest, rewarming time, time of anesthesia recovery after surgery, and volume of drainage of chest fluid within 24 hours, and analyze the occurrence rate and death rate of transient neurologic deficit(TND), permanent neurological dysfunction(PND), spinal cord complication, and complication of vital visceral organs.Results: The extracorporeal circulation time, cooling time, cardiac muscle blocking time, low-discharge cerebral perfusion time, time of circulatory arrest, rewarming time, and time of anesthesia recovery after surgery of Group A are significantly bigger than those of Group B( P<0.05), and the volume of drainage of chest fluid within 24 hours of Group A is obviously more than that of Group B( P<0.05). There is no statistical significance between the occurrence rate and death rate of TND, PND and complication of vital visceral organs of the two groups( P>0.05).Conclusion: Conclusion: Proficient operation technique should be guaranteed in this experiment. Under this premise, the effects of cerebral protection and protection of vital visceral organs are the same under the temperature of circulatory arrest of 25℃ and 20℃, and the cooling time and rewarming time have been shortened, so the time of operation is shortened as well. And the postoperative blood loss and damage of the engine body of the patients have also been reduced. It’s worth further research to confirm whether it can increase the temperature ofcirculatory arrest.