Biomarker Measurements
ROTEM data is presented in Figure 3. At T0 there was no significant difference in clotting time (CT) in INTEM or HEPTEM between groups (159s [140-170] vs 170s [159-180], p= 0.08 and 156s [ 138-168] vs 163s [150-180], p= 0.21). During CPB, HEPTEM CT increased markedly in both groups and was significantly higher in the ATAAD group at T2 (212s [202-239] vs 198s [193-236], p= 0.05). At the end of surgery (T3), the HEPTEM CT recovered, although not to preoperative levels and was significantly higher in the ATAAD group (187s [166-203] vs 166s [151-173], p< 0.01). The CT in INTEM and HEPTEM was significantly more prolonged in the ATAAD group at T3 compared to T0 (191s [179-211] vs 159s [140-170], p< 0.01 and 187s [166-203] vs 156s [138-168], p< 0.01). In the control group, INTEM CT was significantly longer at T3compared to T0 (184s [162-196] vs 170s [159-180], p= 0.03) but not HEPTEM CT (166s [151-173] vs 163s [150-180], p= 0.93).
EXTEM
There was a significant difference in EXTEM CT at T2(87s [76-107] vs 76s [73-84], p =0.03) and a trend towards it at T3 (59s [54-67] vs 64s [60-68],p =0.07). At the end of surgery, CT in the control group was significantly longer than preoperative levels (64s [60-68] vs 60s [56-65], p= 0.05) and in the ATAAD group there was a trend towards shorter CT compared to preoperative (59s [54-67] vs 62s [56-71], p =0.06).
The maximum clot firmness (MCF) in EXTEM was lower in the ATAAD group compared to the control group at T1, T2,and T5 (41mm [34-41] vs 55mm [51-61],p< 0.001, 50mm [44-55] vs 57mm [54-62],p= 0.001 and 69mm [66-72] vs 73mm [72-74],p= <0.01, respectively) and had a similar trend at T0 (59mm [56-65] vs 64mm [58-68],p= 0.07). EXTEM MCF was also lower in the control group at the end of surgery compared to preoperative levels (61mm [59-65] vs 64mm [58-68], p= 0.02) but not in the ATAAD group (61mm [58-64] vs 59mm [56-65], p= 0.15).
FIBTEM
The preoperative FIBTEM MCF was significantly lower in the ATAAD group compared to the control group (12.0mm [10.0-15.0] vs 16.5mm [13.5-20.0], p= 0.03), and the pattern persisted during the operation (at T1 9.0mm [5.5-11.5] vs 13.0mm [10.0-16.3], p< 0.01 and at T2 9.0mm [7.0-12.0] vs 13.5mm [11.3-15.0], p< 0.01). There was no difference in FIBTEM MCF at the end of surgery (T3) or the first postoperative day (T4) (p= 0.91 and p= 0.51, respectively), however at T5, MCF was again lower in the ATAAD group (28.5mm [25.0-37.3] vs 37.0mm [35.0-38.0], p< 0.01).