{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T23:10:10Z","timestamp":1758928210969,"version":"3.44.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":169,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Heart Lung and Blood Institute\/National Institute of Health","award":["T32HL007849"],"award-info":[{"award-number":["T32HL007849"]}]},{"name":"National Center for Advancing Translational Science of the National Institutes of Health Award","award":["UL1TR003015\/KL2TR003016"],"award-info":[{"award-number":["UL1TR003015\/KL2TR003016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aorta (Stamford)"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Deep hypothermic circulatory arrest (DHCA) is associated with coagulopathy but facilitates aortic arch surgery. Conflicting data suggest moderate hypothermic circulatory arrest (MHCA) may reduce transfusion requirements. We hypothesized MHCA would reduce transfusion requirements.<\/jats:p><jats:p>We studied patients undergoing aortic hemiarch surgery for nondissected, aneurysmal disease from July 2014 to May 2023 utilizing a multicenter collaborative. Patients were stratified by DHCA (14.1\u201320\u00b0C) and MHCA (20.1\u201328\u00b0C). Packed red blood cells (pRBC), fresh frozen plasma (FFP), cryoprecipitate, and platelet transfusion requirements were assessed. A negative binomial model accounting for hospital random effect was fitted to identify risk factors for increased transfusion requirements.<\/jats:p><jats:p>Of the 451 patients undergoing hemiarch surgery, 373 (83%) had MHCA and 78 (17%) had DHCA. MHCA patients had shorter cardiopulmonary bypass (135\u2009minutes [105, 182] vs. 216\u2009minutes [183, 263], p\u2009&lt;\u20090.001) and circulatory arrest times (12\u2009minutes [8, 17] vs. 21\u2009minutes [16, 34], p\u2009&lt;\u20090.001). MHCA patients received fewer pRBC (0 [0, 1] vs. 1 [0, 3], p\u2009&lt;\u20090.001), FFP (0 [0, 3] vs. 2 [0, 4], p\u2009=\u20090.003), cryoprecipitate (1 [0, 1] vs. 1 [0, 2], p\u2009=\u20090.045), and platelet transfusions (0 [0, 1] vs. 2 [0, 2], p\u2009&lt;\u20090.001). Unadjusted operative mortality was lower in the MHCA group (1.9 vs. 7.7%, p\u2009&lt;\u20090.01). After risk adjustment, MHCA was associated with reduced FFP transfusion requirements (\u03b2\u2009=\u2009\u22120.48, SE\u2009=\u20090.2, p\u2009=\u20090.017). Increasing bypass time per minute was associated with increased pRBC (\u03b2\u2009=\u2009+0.01, 95% CI\u2009=\u20090.006\u20130.013, p\u2009&lt;\u20090.001), FFP (\u03b2\u2009=\u2009+0.006, 95% CI\u2009=\u20090.004\u20130.009, p\u2009&lt;\u20090.001), cryoprecipitate (\u03b2\u2009=\u2009+0.008, 95% CI\u2009=\u20090.005\u20130.01, p\u2009&lt;\u20090.001), and platelet transfusions (\u03b2\u2009=\u2009+0.009, 95% CI\u2009=\u20090.006\u20130.011, p\u2009&lt;\u20090.001).<\/jats:p><jats:p>MHCA was associated with decreased mortality and FFP transfusions in aortic hemiarch repair. MHCA may mitigate transfusion needs via shorter cardiopulmonary bypass time compared with DHCA.<\/jats:p>","DOI":"10.1055\/a-2693-4175","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T23:17:22Z","timestamp":1758151042000},"page":"056-064","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Cooling Strategies on Transfusion Requirements in Aortic Hemiarch Surgery"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5660-321X","authenticated-orcid":false,"given":"Anthony V.","family":"Norman","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjana","family":"Challa","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genevieve","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander M.","family":"Wisniewski","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond J.","family":"Strobel","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Mazzeffi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Carilion Clinic, Roanoke, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, INOVA Heart and Vascular Institute, Falls Church, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, INOVA Heart and Vascular Institute, Falls Church, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Kontos","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Quader","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenan","family":"Yount","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas R.","family":"Teman","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ourania","family":"Preventza","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared P.","family":"Beller","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"issue":"06","key":"ref1","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":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"2634","DOI":"10.1053\/j.jvca.2023.08.139","article-title":"Hypothermic circulatory arrest in adult aortic arch surgery: a review of hypothermic circulatory arrest and its anesthetic implications","volume":"37","author":"S Ghia","year":"2023","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.jtcvs.2016.08.014","article-title":"Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? 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