Patient population
Each site’s institutional review board has approved this study. Because of its retrospective nature, the local ethics committees waived the need for specific patient consent.
This is a retrospective cohort observational multicentric study that utilizes data from 7 institutional databases of patients who underwent elective aortic arch surgery under circulatory arrest (CA), from 2018 till 2021.
Patients with acute aortic syndrome or with chronic aortic dissections were excluded. Two-hundred-fifty patients were included and stratified according to the adjunctive CP techniques used, if any. Forty cases were excluded because of missing data (n=11) or techniques not included in the analysis (n=26). Three more cases, defined as “outliers”, were excluded as well. Finally, the cases included in the analysis were 210. Patients were then divided in two groups according to the surgical strategy. The first group (n=59) included patients operated on during DHCA at ≤ 20°C, without any CP, and DR (DHCA+DR group). Cerebral and lower body CA coincided. The second group (n=151) included patients operated on during MHCA, median temperature 26°C, and ACP (MHCA+ACP group). The brain was continuously perfused and the duration of CA involved only the lower body.