SCTS Annual Meeting 2025: Abstracts

Methods: Single-centre, retrospective analysis of patients who underwent frozen elephant trunk for aortic arch replacement.'Beating heart' patients, receiving warm blood perfusion to aortic root during frozen elephant trunk implantation, were compared to 'cardioplegic arrest' .Primary outcome was inotrope requirements(adrenaline; dopamine) and vasopressors(noradrenaline; vasopressin).Secondary outcomes consisted of thirty day mortality and veno-arterial extracorporeal membrane oxygenation incidence.Results: Of 135 patients, twice as many underwent 'beating heart'(n = 91; 67%) compared to 'cardioplegic arrest'(n = 45; 33%).Preoperative demographics were comparable for age, gender, left ventricular function, redo surgery and surgical risk.'Beating heart' was less likely to present for urgent/emergent surgery(41% versus 87%; p < 0.01) and more likely to undergo aneurismal disease surgery(53% versus 6%;p < 0.01).Cardio-pulmonary bypass, aortic cross-clamp, deep hypothermic circulatory arrest and antegrade cerebral protection times were comparable.By intensive care unit arrival, 'beating heart' had tendency to lower adrenaline requirements(0.02± 0.05 versus 0.10 ± 0.51 mcg/kg/min;p = 0.15), but similar dopamine(2.04 ± 2.21 versus 2.06 ± 2.06 mcg/kg/min), noradrenaline(0.03± 0.02 versus 0.03 ± 0.04 mcg/kg/min), and vasopressin(0.008± 0.024 versus 0.007 ± 0.020 units/min).30-day mortality(15% versus 13%) and venoarterial extracorporeal membrane oxygenation incidence(3% versus 2%) was comparable.Conclusions: 'Beating heart' surgery has a tendency towards lower adrenaline requirement following aortic arch replacement surgery with frozen elephant trunk.No difference in 30 day mortality or vasopressors was observed.