ArticleThe Journal of thoracic and cardiovascular surgery2014
Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.
Article in The Journal of thoracic and cardiovascular surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Proximal versus extensive repair in acute type A aortic dissection: an updated systematic review and meta-analysis.General thoracic and cardiovascular surgery · 2022Pooled it
- Article
- Hybrid cerebral perfusion in aortic arch surgery: Bridging antegrade and retrograde techniques.JTCVS techniques · 2026Article
- Anesthetic Management for Proximal Aortic Repair.Seminars in cardiothoracic and vascular anesthesia · 2025Review
- High Flow, High-Pressure Retrograde Cerebral Perfusion at 28°C is Safe and Effective for Hemiarch Replacement of the Ascending Aorta.Aorta (Stamford, Conn.) · 2024Article
- Cerebral protection: Antegrade cerebral perfusion in the modern era. Does temperature matter?JTCVS techniques · 2024Article
- Cannula Placement for Cerebral Protection Without Circulatory Arrest in Patients Undergoing Hemiarch Aortic Aneurysm Repair.Texas Heart Institute journal · 2024Article
- Cerebral protection strategies for type A aortic dissection repair.Indian journal of thoracic and cardiovascular surgery · 2023Review
- Post-Operative Kidney Function Using Deep Hypothermic Circulatory Arrest (DHCA) in Aortic Arch Operation.International journal of nephrology and renovascular disease · 2022Article
- Does deeper hypothermia reduce the risk of acute kidney injury after circulatory arrest for aortic arch surgery?European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2021Article
- Modified Technique for Retrograde Cerebral Perfusion during Hemiarch Aortic Replacement.Aorta (Stamford, Conn.) · 2021Article
- Aortic valve repair with a newly approved geometric annuloplasty ring in patients undergoing proximal aortic repair: early results from a single-centre experience.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2020Article
- Neuroprotective Strategies in Repair and Replacement of the Aortic Arch.The International journal of angiology : official publication of the International College of Angiology, Inc · 2018Review
- Simple retrograde cerebral perfusion is as good as complex antegrade cerebral perfusion for hemiarch replacement.Journal of visualized surgery · 2018Article
- Con-debate: short circulatory arrest times in arch reconstructive surgery: is simple retrograde cerebral perfusion or hypothermic circulatory arrest as good or better than complex antegrade cerebral perfusion for open distal involvement or hemi-arch?Journal of visualized surgery · 2018Article
- Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.The Journal of thoracic and cardiovascular surgery · 2016Article
- Evolving practice pattern changes and outcomes in the era of hybrid aortic arch repair.Journal of vascular surgery · 2016Article
- Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest.The Annals of thoracic surgery · 2016Article
- Prolonged postoperative respiratory support after proximal thoracic aortic surgery: Is deep hypothermic circulatory arrest a risk factor?Journal of critical care · 2016Article
- How to Perfuse: Concepts of Cerebral Protection during Arch Replacement.BioMed research international · 2015Review
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7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe choice of cerebral perfusion strategy for aortic arch surgery has been debated, and the superiority of antegrade (ACP) or retrograde (RCP) cerebral perfusion has not been shown. We examined the early and late outcomes for ACP versus RCP in proximal (hemi-) arch replacement using deep hypothermic circulatory arrest (DHCA).
methodsA retrospective analysis of a prospectively maintained database was performed for all patients undergoing elective and nonelective hemiarch replacement at a single referral institution from June 2005 to February 2013. Total arch cases were excluded to limit the analysis to shorter DHCA times and a more uniform patient population for whom clinical equipoise regarding ACP versus RCP exists. A total of 440 procedures were identified, with 360 (82%) using ACP and 80 (18%) using RCP. The endpoints included 30-day/in-hospital and late outcomes. A propensity score with 1:1 matching of 40 pre- and intraoperative variables was used to adjust for differences between the 2 groups.
resultsAll 80 RCP patients were propensity matched to a cohort of 80 similar ACP patients. The pre- and intraoperative characteristics were not significantly different between the 2 groups after matching. No differences were found in 30-day/in-hospital mortality or morbidity outcomes. The only significant difference between the 2 groups was a shorter mean operative time in the RCP cohort (P = .01). No significant differences were noted in late survival (P = .90).
conclusionsIn proximal arch operations using DHCA, equivalent early and late outcomes can be achieved with RCP and ACP, although the mean operative time is significantly less with RCP, likely owing to avoidance of axillary cannulation. Questions remain regarding comparative outcomes with straight DHCA and lesser degrees of hypothermia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.