Key result
Modified in-situ bilateral antegrade cerebral perfusion significantly reduced postoperative neurological complications compared to unilateral perfusion during total arch replacement for TAAD.
Why the study?
Differences in cerebral protection between modified in-situ bilateral antegrade cerebral perfusion and unilateral antegrade cerebral perfusion under moderate hypothermic circulatory arrest during total arch replacement for type A aortic dissection were unclear.
Does modified in-situ bilateral antegrade cerebral perfusion reduce postoperative neurological complications in patients with type A aortic dissection undergoing total arch replacement?
Cohort
No
Does modified in-situ bilateral antegrade cerebral perfusion reduce postoperative neurological complications in patients with type A aortic dissection undergoing total arch replacement?
Modified in-situ bilateral antegrade cerebral perfusion provides more effective cerebral protection and reduces postoperative neurological complications compared to unilateral perfusion during total arch replacement for type A aortic dissection.
May support bilateral perfusion strategy in TAAD arch repair; leaves open confirmation in randomized trials.
Background To investigate the differences in cerebral protection between modified in-situ bilateral antegrade cerebral perfusion (mBACP) and unilateral antegrade cerebral perfusion (UACP) under moderate hypothermic circulatory arrest (MHCA) during total arch replacement for type A aortic dissection (TAAD). Methods A retrospective cohort study was conducted to analyze clinical data of TAAD patients who underwent total arch replacement under MHCA at our institution. Patients were divided into mBACP and UACP groups according to the cerebral perfusion method. Demographic characteristics, perioperative indicators, and postoperative neurological complications were compared between the two groups. Results The mBACP group had shorter circulatory arrest time, more stable intraoperative temperature control, and significantly lower incidence of postoperative neurological complications compared to the UACP group. Conclusion Under moderate hypothermic circulatory arrest conditions, modified in-situ bilateral antegrade cerebral perfusion provides more effective cerebral protection than unilateral antegrade cerebral perfusion, reduces postoperative neurological complications, and may extend the safe circulatory arrest time limit.
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Zhang et al. (2025) conducted a cohort in Type A aortic dissection (TAAD). Modified in-situ bilateral antegrade cerebral perfusion (mBACP) vs. Unilateral antegrade cerebral perfusion (UACP) was evaluated on Postoperative neurological complications. Modified in-situ bilateral antegrade cerebral perfusion significantly reduced postoperative neurological complications compared to unilateral perfusion during total arch replacement for TAAD.
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