ArticleJTCVS open2026
Adjusted comparison of antegrade cerebral perfusion techniques during prolonged circulatory arrest in surgery for acute type A aortic dissection.
Article in JTCVS open, 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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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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Abstract
Objective: To investigate differences in neurologic outcomes between unilateral and bilateral antegrade cerebral perfusion during prolonged circulatory arrest in surgery for acute type A aortic dissection (ATAAD). Methods: Patients who underwent surgery for ATAAD between 2013 and 2023 receiving either unilateral antegrade cerebral perfusion (uACP) or bilateral antegrade cerebral perfusion (bACP) during prolonged caudal circulatory arrest (≥30 minutes) were included in the primary study cohort. Preoperative computed tomography scans were analyzed in terms of Type-Entry-Malperfusion classification and supra-aortic dissection patterns. After propensity score matching, the groups were compared in terms of clinical outcomes, including new postoperative strokes. Results: A total of 382 patients (206 uACP and 176 bACP) were included. The matched cohort comprised 2 balanced groups with 170 patients (85 in each group). The median circulatory arrest time was 44 (interquartile range [IQR], 36-57) minutes in the uACP group and 44 (IQR, 40-56) minutes in the bACP group ( Conclusions: Both uACP and bACP are adequate cerebral perfusion strategies during circulatory arrest exceeding 30 minutes in surgery for ATAAD. Additional intraoperative and anatomic factors may be considered to determine the optimal selective cerebral perfusion strategy.
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