Immediate results of aortic arch surgery in patients with mild hypothermic circulatory arrest and different types of cerebral perfusion

Aim. Emphasis in the study was placed on the analysis of the immediate results of interventions on the aortic arch in patients operated under antegrade/ retrograde cerebral perfusion and mild hypothermic circulatory arrest. Methods. Data on 49 patients who underwent intervention on the aortic arch with antegrade (24 patients - group 1) or retrograde (25 patients - group 2) cerebral perfusion and moderate hypothermic circulatory arrest over a period from 2011 to 2015 was collected and analyzed retrospectively. 26.5 % (13) of patients were treated for acute type I aortic dissection. Bicuspid aortic valve was present in 33 % (16), Marfan syndrome was in 4 % (2), aortic regurgitation grade II and III accounted for 56 % (27). Results. The mean age of patients was 58±11 and 58±12 years (р=0.9), males amounted to 83 % and 76 % (р=0.524), NYHA functional class was 2.9±0.5 and 2.8±0.8 (р=0.689) in group 1 and group 2, respectively. Cardiopulmonary bypass time amounted to 190±44 and 207±50 min (р=0.227), aortic cross-clamp time ran to 119±32 and 113±26 min (р=0.503), circulatory arrest lasted 21 ±12 and 21 ±15 min (р=0.968) in group 1 and group 2, respectively. Postoperative mortality, prolonged ICU time, complications, stroke were 0 and 8 % (р=0.157), 71 and 48 % (р=0.182), 67 and 64 % (р=0.831), 12.5 and 12 % (р=0.955) in group 1 and group 2, respectively. Conclusion. Antegrade and retrograde cerebral perfusion under a short mild hypothermic circulatory arrest during aortic arch surgery showed comparable immediate results. Antegrade cerebral perfusion should be used in most cases as more physiological.