{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:40:32Z","timestamp":1792698032085,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The aim of this retrospective multicentre study was to investigate and compare clinical outcomes of unilateral and bilateral antegrade cerebral perfusion (ACP) strategies on cerebral protection during surgery for type A aortic dissection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Data from 646 patients who underwent surgical repair of thoracic type A aortic dissection using unilateral and bilateral ACP with moderate hypothermic circulatory arrest in 3 cardiac surgical institutions between 2008 and 2018 were analysed. Propensity matching was performed to assess which technique ensured better outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Unilateral and bilateral ACP techniques were performed in 250 (39%) and in 396 (61%) patients, respectively. Propensity score analysis identified 189 matched pairs. In the matched cohort, the lowest core temperature was 27.5\u00b0C and 28\u00b0C in the bilateral and unilateral groups, respectively (P\u2009&amp;lt;\u20090.001). The unilateral technique required significantly shorter aortic cross-clamp and cardiopulmonary bypass times than bilateral technique [82\u2009min vs 100\u2009min (P\u2009&amp;lt;\u20090.001); 170\u2009min vs 195\u2009min (P\u2009&amp;lt;\u20090.001)]. The 30-day mortality was comparable (P\u2009=\u20090.325). The bilateral group reported a significantly higher incidence of permanent neurologic deficits (P\u2009&amp;lt;\u20090.001), left brain hemisphere stroke (P\u2009=\u20090.007) and all-combined complications (P\u2009&amp;lt;\u20090.001). Ten-year survival was comparable (P\u2009=\u20090.45).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Unilateral and bilateral ACP are both valid brain protection strategies in the landscape of aortic arch surgery. While admitting all the study limitations, unilateral technique could offer some clinical advantages.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical registration number<\/jats:title>\n                  <jats:p>76049<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab341","type":"journal-article","created":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T19:18:26Z","timestamp":1625253506000},"page":"828-835","source":"Crossref","is-referenced-by-count":26,"title":["Unilateral versus bilateral cerebral perfusion during aortic surgery for acute type A aortic dissection: a multicentre study"],"prefix":"10.1093","volume":"61","author":[{"given":"Antonio","family":"Piperata","sequence":"first","affiliation":[{"name":"Department of Cardiology, Thoracic, Vascular, and Public Health Sciences, University of Padua, Padova, Italy"},{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masazumi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5882-8925","authenticated-orcid":false,"given":"Mathieu","family":"Pernot","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Metras","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9128-9740","authenticated-orcid":false,"given":"Gregory","family":"Kalscheuer","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-4562","authenticated-orcid":false,"given":"Martina","family":"Avesani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoracic, Vascular, and Public Health Sciences, University of Padua, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Barandon","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Peltan","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Lorenzoni","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vjola","family":"Jorgji","sequence":"additional","affiliation":[{"name":"Hacohen Lab, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Gregori","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5339-6534","authenticated-orcid":false,"given":"Shinya","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Labrousse","sequence":"additional","affiliation":[{"name":"Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), H\u00f4pital Cardiologique de Haut-L\u00e9v\u00e8que, Bordeaux University Hospital, 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