{Reference Type}: Journal Article
{Title}: The optimal degree of core temperature for hypothermic circulatory arrest in complex aortic arch surgery: results from 1310 patients.
{Author}: Zhang K;Zhou C;Gao S;Ji Y;Qiu J;Cao F;Qiu J;Yu C;
{Journal}: Eur J Cardiothorac Surg
{Volume}: 66
{Issue}: 2
{Year}: 2024 Aug 2
{Factor}: 4.534
{DOI}: 10.1093/ejcts/ezae311
{Abstract}: <B>OBJECTIVE: </B>The optimal core temperature for hypothermic circulatory arrest during aortic arch surgery remains contentious. This study aims to evaluate patient outcomes under various temperatures within a large single-centre cohort.<BR><B>METHODS: </B>Between 2010 and 2018, patients diagnosed with type A aortic dissection underwent total arch replacement at Fuwai Hospital were enrolled. They were categorized into 4 groups: deep hypothermia group, low-moderate hypothermia group, high-moderate hypothermia group and mild hypothermia group. Clinical data were analysed to ascertain differences between the groups.<BR><B>RESULTS: </B>A total of 1310 patients were included in this cohort. Operative mortality stood at 6.9% (90/1310), with a higher incidence observed in the deep hypothermia group [29 (12.9%); 35 (6.9%); 21 (4.8%); 5 (3.4%); all adjusted P < 0.05]. Overall 10-year survival was 80.3%. Long-term outcomes did not significantly differ among the groups. Multivariable logistic analysis revealed a protective effect of higher core temperature on operative mortality (odds ratio 0.848, 95% confidence interval 0.766-0.939; P = 0.001). High-moderate hypothermia emerged as an independent protective factor for operative mortality (odds ratio 0.303, 95% confidence interval 0.126-0.727; P = 0.007). Multivariable Cox analysis did not detect an effect of hypothermic circulatory arrest on long-term survival (all P > 0.05).<BR><B>CONCLUSIONS: </B>High-moderate hypothermia (24.1-28°C) offers the most effective protection against surgical mortality and is therefore recommended. Different hypothermic circulatory arrest temperatures do not influence long-term survival or quality of life.