ArticleJTCVS open2026
Cerebral protection in extended arch repair 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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Authors and funding
9 authors.
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Abstract
Objective: To evaluate the association between cerebral perfusion strategy and neurologic outcomes following extended arch repair for acute type A aortic dissection (ATAAD). Methods: We identified patients who underwent extended arch repair for ATAAD at our institution between 2002 and 2024. Patients were stratified by cerebral perfusion strategyL antergrade certebral perfusion (ACP) or retrograde cerebral perfusion (RCP). Outcomes included stroke and a composite of 30-day mortality, stroke, and temporary neurologic dysfunction. Multivariable analysis was used to evaluate the association between cerebral perfusion strategy and the composite outcome. Results: A total of 206 patients met the study inclusion criteria (median age, 58.7 years; 25.2% female). ACP was the most common cerebral perfusion strategy (58.7%; n = 121), followed by combined ACP and RCP (32.0%; n = 66) and then RCP (9.2%; n = 19). The median circulatory arrest time was longer in cases using combined ACP and RCP (62 minutes) compared to ACP (38 minutes) or RCP (34 minutes) ( Conclusions: Despite prolonged circulatory arrest times, cases using combined ACP and RCP were not associated with an increased rate of stroke. The combined approach may help extend the safe duration of circulatory arrest in extended arch repair for ATAAD.
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