P365. Unilateral and bilateral cerebral perfusion during total arch replacement surgery: which is better?
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Fuwai Hospital, National Center for Cardiovascular Diseases
beijing, Beijing
China - Contact Me
Yumeng Ji, born in 1997, studying for medical doctor in Cardiac Surgery, Fu Wai Hospital, Chinese Academy of Medical Sciences, China. Received master degree from Nanjing Medical University in 2020. Foxing on the treatment of aortic dissection, epicardial adipose tissue.
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objectives: To compare the impact of unilateral antegrade cerebral perfusion (uni-ACP) and bilateral antegrade cerebral perfusion (bi-ACP) on perioperative complications and short-term follow-up outcomes in Asian patients of total arch replacement surgery.
Methods: We retrospectively collected clinical baseline characteristics and perioperative complications of 1052 patients who underwent total arch replacement surgery in China Cardiovascular Center-Fuwai Hospital from January 2019 to December 2022. Patients were separated into unilateral (n=448) and bilateral (n=604) antegrade cerebral perfusion groups We selected 372 pairs of patients for propensity score matching and evaluated baseline differences between the two groups and analyze perioperative and short-term postoperative complications such as bleeding, infection, redissection and organ damage, especially neurological injury such as cerebrovascular accident(CVA), delirium, etc.
Results: Perioperative mortality and postoperative complications such bleeding, infection, and redissection were similar between groups with a 30-day mortality of 8.5% for uni-ACP versus 9.2% for bi-ACP (P=0.46). Notably, the incidence of postoperative delirium was significantly lower in the uni-ACP group (5% vs. 12%, p=0.03). Between uni-ACP and bi-ACP groups, overall CVA rate (4.3% vs. 3.8%, p=0.4) were not significantly different. The short-term survival was similar between the two groups, p=0.27, (1-year:93.4% vs. 94.2%).
conclusions: In total arch replacement surgery, both uni-ACP and bi-ACP are considered valid strategies for brain protection. Notably, the use of bi-ACP demonstrates a significant reduction in the incidence of postoperative delirium.
Authors
Juntao Qiu (1), Yumeng Ji (2), Cuntao Yu (3)
Institutions
(1) N/A, China, (2) Fuwai Hospital, Beijing, Beijing, (3) Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular, Beijing, Beijing
Methods: We retrospectively collected clinical baseline characteristics and perioperative complications of 1052 patients who underwent total arch replacement surgery in China Cardiovascular Center-Fuwai Hospital from January 2019 to December 2022. Patients were separated into unilateral (n=448) and bilateral (n=604) antegrade cerebral perfusion groups We selected 372 pairs of patients for propensity score matching and evaluated baseline differences between the two groups and analyze perioperative and short-term postoperative complications such as bleeding, infection, redissection and organ damage, especially neurological injury such as cerebrovascular accident(CVA), delirium, etc.
Results: Perioperative mortality and postoperative complications such bleeding, infection, and redissection were similar between groups with a 30-day mortality of 8.5% for uni-ACP versus 9.2% for bi-ACP (P=0.46). Notably, the incidence of postoperative delirium was significantly lower in the uni-ACP group (5% vs. 12%, p=0.03). Between uni-ACP and bi-ACP groups, overall CVA rate (4.3% vs. 3.8%, p=0.4) were not significantly different. The short-term survival was similar between the two groups, p=0.27, (1-year:93.4% vs. 94.2%).
conclusions: In total arch replacement surgery, both uni-ACP and bi-ACP are considered valid strategies for brain protection. Notably, the use of bi-ACP demonstrates a significant reduction in the incidence of postoperative delirium.
Authors
Juntao Qiu (1), Yumeng Ji (2), Cuntao Yu (3)
Institutions
(1) N/A, China, (2) Fuwai Hospital, Beijing, Beijing, (3) Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular, Beijing, Beijing
Presentation Duration
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