Application Of Moderate Hypothermic Circulatory Arrest With Antegrade Cerebral Perfusion In Surgery Of Stanford Type A Aortic Dissection

Objective:To study the application of moderate hypothermic circulatory arrest during aortic arch surgery in the adult patientsMethods:We collected 32 cases of Stanford type A aortic dissection patients undergoing surgical treatment in our hospital from January 2016 to December 2017,including 20 males and 12 females.The age of patients was 33-60 years(average age 46.9 ± 7.0 years),the weight was 57-80Kg(average weight 64.4 ± 9.5Kg).According to the lowest temperature during the operation,the group was divided into deep hypothermia group(DH,18 cases,nasopharyngeal temperature<24 ?)and moderate hypothermia group(MH,14 cases,nasopharyngeal temperature 24-28 °C).The intraoperative and postoperative recovery of the two groups was observed and compared.Results:This study found that in the aortic clamping time[(114.46 ± 42.80)min VS.(113.50 ± 42.65)min];selective cerebral perfusion time[(26.82 ± 6.45)min VS.(24.42 ± 6.50)min],the difference was not statistically significant(P>0.05).There were significant differences in the cardiopulmonary bypass time[(270.05 ± 25.08)min VS.(210.86 ± 24.67)min],the postoperative recoverytime[(37.95 ± 15.40)h VS.(20.60 ± 10.45)h],intubation time[(66.58 ± 15.69)hVS.(45.90±12.85)h];length of ICU[(9.09±2.75)d VS.(4.50±2.10)d]of the two groups.There were 8 cases of cognitive dysfunction after operation,including 6 cases in DH group and 2 cases in MH group.The difference was statistically significant.Conclusion:Compared with deep hypothermic circulatory arrest,the application of moderate hypothermic circulatory antegrade cerebral perfusion in Stanford type A aortic dissection has good brain protection.