ArticleJournal of thoracic disease2026
Safety and efficacy of mild hypothermic circulatory arrest with bilateral cerebral perfusion in acute aortic dissection surgery: a retrospective cohort study.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency requiring urgent surgical intervention, during which cerebral protection is paramount. In aortic dissection surgery, the moderate hypothermic circulatory arrest combination with unilateral selective antegrade cerebral perfusion is a commonly used cerebral protection strategy. However, compared with mild hypothermia, moderate hypothermia has drawbacks such as prolonged cardiopulmonary bypass time. Whether mild hypothermic circulatory arrest can overcome the disadvantages of moderate hypothermia and provide safe cerebral protection remains controversial. This retrospective cohort study aimed to assess the safety and efficacy of mild hypothermic circulatory arrest (Mild-HCA) with bilateral cerebral perfusion in surgeries for ATAAD. Methods: From November 2022 to April 2025, 89 consecutive patients with ATAAD who underwent open surgical repair were retrospectively analyzed. Patients were categorized into two groups: a mild hypothermia with bilateral cerebral perfusion group (Group A, n=48) and a moderate hypothermia with unilateral cerebral perfusion group (Group B, n=41). Postoperative outcomes, including permanent neurological dysfunction (PND), temporary neurological dysfunction (TND) and other complications, were compared between two subgroups. Results: There were no statistically significant differences between the two subgroups in the incidence of central nervous system complications or in-hospital mortality. However, patients in the Mild-HCA group had significantly shorter durations of cardiopulmonary bypass (CPB), mechanical ventilation, and intensive care unit stay compared with the moderate-HCA group (all P<0.05). Conclusions: Mild-HCA with bilateral cerebral perfusion appears to be a safe and feasible strategy for surgical management of ATAAD offering the advantage of reduced perioperative support time without increasing neurological or mortality risks.
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