{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:46:17Z","timestamp":1774068377564,"version":"3.50.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac cardiovasc Surg"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>\n            Objectives\u2003Surgery for acute type A aortic dissection (AAD) remains a surgical challenge with considerable risk of morbidity and mortality. Antegrade cerebral perfusion (ACP) has been popularized, offering a more physiologic method of brain perfusion during complex aortic arch repair, often necessary in setting of AAD. The safe limits of this approach under moderate-to-mild systemic hypothermic circulatory arrest (\u2265 28\u00b0C) are yet to be defined. Thus, the current study investigates our clinical results after surgical treatment for AAD in patients with a selective ACP and systemic circulatory arrest time of\u2009\u2265\u200960 minutes in moderate-to-mild hypothermia (\u2265 28\u00b0C).<\/jats:p><jats:p>\n            Methods\u2003Between January 2000 and April 2016, 63 consecutive patients underwent surgical treatment for AAD employing selective ACP during moderate-to-mild systemic hypothermia (\u2265 28\u00b0C) with prolonged ACP and circulatory arrest times. Patients' mean age was 59\u2009\u00b1\u200915 years, and 39 patients (62%) were men. Hemiarch replacement and total arch replacement were performed in 13 (21%) and 50 (79%) patients, respectively. Frozen elephant trunk, arch light, and elephant trunk technique were performed in nine (14%), six (10%), and three patients (5%), respectively. Clinical data were prospectively entered into our institutional database. Mean late follow-up was 6\u2009\u00b1\u20094 years and was 98% complete.<\/jats:p><jats:p>\n            Results\u2003Cardiopulmonary bypass time accounted for 245\u2009\u00b1\u200981 minutes and the myocardial ischemic time accounted for 140\u2009\u00b1\u200943 minutes. Mean duration of ACP was 74\u2009\u00b1\u200912 minutes. The mean lowest core temperature accounted for 28.9\u2009\u00b1\u20090.8\u00b0C. Unilateral ACP was performed in 44 patients (70%); bilateral ACP was used in the remaining 19 patients (30%). Intensive care unit stay reached 6\u2009\u00b1\u20095 days. New onset of acute renal failure requiring hemofiltration was observed in 8% of patients (n\u2009=\u20095). New postoperative permanent neurologic deficits were found in five patients (8%) and transient neurologic deficits in six patients (10%). There was one case of paraplegia. Thirty-day mortality and in-hospital mortality were 8 (n\u2009=\u20095) and 11% (n\u2009=\u20097), respectively. Overall survival at 5 years was 76\u2009\u00b1\u20099%.<\/jats:p><jats:p>\n            Conclusion\u2003Our preliminary data suggest that selective ACP during moderate-to-mild systemic hypothermic circulatory arrest (\u2265 28\u00b0C) can safely be applied for more than 1 hour even in the setting of AAD.<\/jats:p>","DOI":"10.1055\/s-0037-1604451","type":"journal-article","created":{"date-parts":[[2017,8,6]],"date-time":"2017-08-06T22:31:09Z","timestamp":1502058669000},"page":"215-221","source":"Crossref","is-referenced-by-count":14,"title":["Is More than One Hour of Selective Antegrade Cerebral Perfusion in Moderate-to-Mild Systemic Hypothermic Circulatory Arrest for Surgery of Acute Type A Aortic Dissection Safe?"],"prefix":"10.1055","volume":"66","author":[{"given":"Nestoras","family":"Papadopoulos","sequence":"first","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petar","family":"Risteski","sequence":"first","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Hack","sequence":"first","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmut","family":"Ay","sequence":"first","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton","family":"Moritz","sequence":"first","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zierer","sequence":"first","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johannes Kepler University, Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"El-Sayed Ahmad","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2017,8,6]]},"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0037-1604451.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T22:30:50Z","timestamp":1522621850000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0037-1604451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,6]]},"references-count":0,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2018,4,1]]},"published-print":{"date-parts":[[2018,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0037-1604451","relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,6]]}}}