{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T23:04:33Z","timestamp":1780009473300,"version":"3.53.1"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>DeBakey type I aortic dissection requires circulatory arrest during arch reconstruction, putting the brain at risk. In resource-limited centers, deep hypothermia can exacerbate coagulopathy and lead to increased bleeding. This study compares outcomes between mild and moderate hypothermia under unilateral cerebral perfusion (UCP).<\/jats:p>\n                  <jats:p>Retrospective analysis of 60 patients who underwent modified Bentall procedures with hemiarch replacement under UCP between 2014 and 2024. Patients were divided into two groups: mild hypothermia (mH, 32\u00b0C; n\u2009=\u200940) and moderate hypothermia (MH, 24\u00b0C; n\u2009=\u200920). Exclusion criteria included bilateral cerebral perfusion, additional procedures (e.g., total arch replacement, bypass surgery), preexisting neurological or renal conditions, and incomplete datasets. Neurological events, blood loss, transfusion requirements, acute kidney injury (AKI), and mortality were assessed.<\/jats:p>\n                  <jats:p>Neurological outcomes (permanent neurological dysfunction and transient neurological dysfunction) were comparable in both groups (20% each). The mH group had significantly lower blood loss (787 vs. 1,183\u2009mL), reduced red blood cell transfusion (200 vs. 828\u2009mL), and less fresh frozen plasma use (259.5\u2009vs. 882\u2009mL). The mH group also had lower rates of AKI (15 vs. 30%), rethoracotomy (10 vs. 22.5%), and infections (10 vs. 20%). Mortality was 20% (mH) versus 35% (MH).<\/jats:p>\n                  <jats:p>Mild hypothermia under UCP provides cerebral protection comparable to moderate hypothermia while reducing coagulopathy, transfusion needs, and complications\u2014particularly relevant for centers in resource-limited countries.<\/jats:p>","DOI":"10.1055\/a-2686-4606","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:57:05Z","timestamp":1757113025000},"page":"305-311","source":"Crossref","is-referenced-by-count":0,"title":["The Effects of Unilateral Cerebral Perfusion Under Mild Hypothermia"],"prefix":"10.1055","volume":"74","author":[{"given":"Nikolozi","family":"Vashakmadze","sequence":"additional","affiliation":[{"name":"West Georgia Heart Center, Tbilisi State Medical University, Kutaisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto","family":"Dapunt","sequence":"additional","affiliation":[{"name":"Batumi Medical Center, Tbilisi State Medical University, Batumi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamuka","family":"Bokuchava","sequence":"additional","affiliation":[{"name":"Bokhua Memorial Cardiovascular Center, Tbilisi State Medical University, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nodar","family":"Pkhakadze","sequence":"additional","affiliation":[{"name":"West Georgia Heart Center, Tbilisi State Medical University, Kutaisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Ghlonti","sequence":"additional","affiliation":[{"name":"West Georgia Heart Center, Tbilisi State Medical University, Kutaisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengiz","family":"Purtskhvanidze","sequence":"additional","affiliation":[{"name":"West Georgia Heart Center, Tbilisi State Medical University, Kutaisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeri","family":"Kuzmenko","sequence":"additional","affiliation":[{"name":"West Georgia Heart Center, Tbilisi State Medical University, Kutaisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1001\/jamacardio.2022.2718","article-title":"Early mortality in type A acute aortic dissection: insights from the International Registry of Acute Aortic Dissection","volume":"7","author":"K M Harris","year":"2022","journal-title":"JAMA Cardiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1161\/CIRCULATIONAHA.123.067022","article-title":"Cognitive effects of body temperature during hypothermic circulatory arrest (GOT ICE trial): a randomized clinical trial comparing outcomes following aortic arch surgery","volume":"149","author":"G C Hughes","year":"2023","journal-title":"Circulation"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/S0022-5223(19)39653-9","article-title":"Prosthetic replacement of the aortic arch","volume":"70","author":"R B Griepp","year":"1975","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1177\/02184923211069186","article-title":"Neuroprotective strategies with circulatory arrest in open aortic surgery - a meta-analysis","volume":"30","author":"I Manoly","year":"2022","journal-title":"Asian Cardiovasc Thorac Ann"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1016\/j.hlc.2022.07.021","article-title":"Deep versus moderate hypothermia in acute type A aortic dissection: a propensity-matched analysis","volume":"31","author":"S S Pupovac","year":"2022","journal-title":"Heart Lung Circ"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40560-024-00774-8","article-title":"Impact of hyper- and hypothermia on cellular and whole-body physiology","volume":"13","author":"T Iba","year":"2025","journal-title":"J Intensive Care"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1055\/s-0041-1725073","article-title":"Reoperative aortic arch surgery under mild systemic hypothermia: two-center experience","volume":"9","author":"P Risteski","year":"2021","journal-title":"Aorta (Stamford)"},{"issue":"02","key":"ref9","first-page":"163","article-title":"Consensus on hypothermia in aortic arch surgery","volume":"2","author":"T D Yan","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1177\/02676591231170707","article-title":"Blood versus crystalloid cardioplegia during triple valve surgery: a single center experience","volume":"39","author":"A Hoyer","year":"2024","journal-title":"Perfusion"},{"issue":"01","key":"ref11","first-page":"44","article-title":"Temperature management in cardiac surgery","volume":"2013","author":"H Saad","year":"2013","journal-title":"Glob Cardiol Sci Pract"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.jtcvs.2016.11.059","article-title":"The impact of temperature in aortic arch surgery patients receiving antegrade cerebral perfusion for >30\u2009minutes: how relevant is it really?","volume":"153","author":"O Preventza","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1016\/j.athoracsur.2012.02.069","article-title":"Hemiarch replacement at 28\u00b0C: an analysis of mild and moderate hypothermia in 500 patients","volume":"93","author":"B G Leshnower","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"ref14","first-page":"1042","article-title":"Selective antegrade cerebral perfusion under mild hypothermia (28\u201330\u00b0C) for arch surgery","volume":"144","author":"A Zierer","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12872-024-04443-4","article-title":"Impact of mild hypothermic circulatory arrest on surgical outcomes in acute type a aortic dissection patients: a single-centre study","volume":"25","author":"Z Li","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"416","DOI":"10.21037\/atm-22-952","article-title":"Comparison of short-term outcomes of mild and moderate hypothermic circulatory arrest in aortic arch surgery: a single center retrospective cohort study","volume":"10","author":"K Zhu","year":"2022","journal-title":"Ann Transl Med"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1447007","DOI":"10.3389\/fcvm.2024.1447007","article-title":"Temperature management in acute type A aortic dissection treatment: deep vs. moderate hypothermic circulatory arrest","volume":"11","author":"H AM Abdulwahab","year":"2024","journal-title":"Front Cardiovasc Med"},{"issue":"08","key":"ref18","first-page":"238","article-title":"Optimization of hypothermic protocols for neurocognitive preservation in aortic arch surgery: a literature review","volume":"11","author":"J Llerena-Velastegui","year":"2024","journal-title":"J Cardiovasc Dev Dis"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"5379","DOI":"10.1111\/jocs.17206","article-title":"Optimal temperature management in aortic arch surgery: a systematic review and network meta-analysis","volume":"37","author":"D Abjigitova","year":"2022","journal-title":"J Card Surg"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1093\/ejcts\/ezt665","article-title":"Visceral organ protection in aortic arch surgery: safety of moderate hypothermia","volume":"46","author":"D Pacini","year":"2014","journal-title":"Eur J Cardiothorac Surg"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1016\/j.athoracsur.2012.11.078","article-title":"Blood transfusion and infection after cardiac surgery","volume":"95","author":"K A Horvath","year":"2013","journal-title":"Ann Thorac Surg"},{"issue":"21","key":"ref22","doi-asserted-by":"crossref","first-page":"e42529","DOI":"10.1097\/MD.0000000000042529","article-title":"Analysis of the effect of mild hypothermic circulatory arrest anesthesia on postoperative lung function in patients with aortic dissection","volume":"104","author":"L Zhou","year":"2025","journal-title":"Medicine (Baltimore)"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.jss.2024.09.023","article-title":"Optimizing therapeutic hypothermia depths in acute type A aortic dissection repair","volume":"303","author":"A M Belyaev","year":"2024","journal-title":"J Surg Res"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/s13019-020-01284-y","article-title":"Different hypothermic and cerebral perfusion strategies in extended arch replacement for acute type a aortic dissection: a retrospective comparative study","volume":"15","author":"S B Dong","year":"2020","journal-title":"J Cardiothorac Surg"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2686-4606.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T22:46:00Z","timestamp":1780008360000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2686-4606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":23,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2026,5,28]]},"published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2686-4606","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}