{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:22:39Z","timestamp":1787008959467,"version":"build-2736575974"},"reference-count":13,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,10,31]],"date-time":"2019-10-31T00:00:00Z","timestamp":1572480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["#Z181100001718197"],"award-info":[{"award-number":["#Z181100001718197"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"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 study was to propose and evaluate the new operative technique of aortic balloon occlusion in total aortic arch replacement (TAR) with the frozen elephant trunk that can significantly decrease the time of circulatory arrest and increase the hypothermic cardiopulmonary bypass (CPB) temperature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Between 2010 and 2018, 1335 patients with aortic dissection who underwent TAR with the frozen elephant trunk were included in the study. The newest 80 cases were treated with aortic balloon occlusion. To illustrate the difference with the new procedure, 1255 conventional TAR cases served as the historical control. Femoral and right axillary artery cannulations were used for CPB and antegrade selective cerebral perfusion. Circulatory arrest was implemented at the nasopharyngeal temperature of 28\u00b0C with continuous antegrade selective cerebral perfusion. After the stent graft was inserted into the true lumen of the descending aorta, the aortic balloon in a sheath was deployed into the stent graft and positioned at the metal part of the stent graft. When the balloon was inflated with enough saline to compress the stent graft, the sheath was simultaneously pressed by hand to properly fix the balloon and avoid displacement. Then femoral perfusion could be resumed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The aortic balloon occlusion technique was successful in all patients, with the median duration of circulatory arrest being 5 (interquartile range 3\u20137) min. The 30-day mortality rate was 6.25% (5\/80), whereas with the conventional method it was 9.40% (118\/1255). The postoperative conscious revival (8.67 vs 11.40\u2009h, P\u2009&lt;\u20090.001) and mechanical ventilation times (19.70 vs 24.45\u2009h, P\u2009=\u20090.02) were significantly shorter. Decreases in postoperative acute kidney injuries (13.75% vs 32.11%, P\u2009=\u20090.001) and liver injuries (8.75% vs 37.61%, P\u2009&lt;\u20090.001) were also observed. The patients were transfused with lesser quantities of red blood cells, plasma and platelets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The aortic balloon occlusion technique is a feasible way to shorten circulatory arrest significantly, to obviate the need for deep hypothermia in TAR with the frozen elephant trunk and to provide favourable protective effects on the central nervous, haematological and visceral systems. With these satisfactory results, this technique deserves further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivz229","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T07:10:10Z","timestamp":1571382610000},"source":"Crossref","is-referenced-by-count":3,"title":["Early outcome of aortic balloon occlusion during total aortic arch replacement with the frozen elephant trunk technique for aortic dissection"],"prefix":"10.1093","author":[{"given":"Yunfeng","family":"Li","sequence":"first","affiliation":[{"name":"Aortic and Vascular Surgery Center, Fuwai Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Aortic and Vascular Surgery Center, Fuwai Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Shi","sequence":"additional","affiliation":[{"name":"Aortic and Vascular Surgery Center, Fuwai Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanxiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Aortic and Vascular Surgery Center, Fuwai Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7803-5068","authenticated-orcid":false,"given":"Xiaogang","family":"Sun","sequence":"additional","affiliation":[{"name":"Aortic and Vascular Surgery Center, Fuwai Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"2019103110093066700_ivz229-B1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jtcvs.2005.09.015","article-title":"Should the \u201celephant trunk\u201d be skeletonized? Total arch replacement combined with stented elephant trunk implantation for Stanford type A aortic dissection","volume":"131","author":"Liu","year":"2006","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2019103110093066700_ivz229-B2","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1161\/CIRCULATIONAHA.110.015081","article-title":"Total arch replacement combined with stented elephant trunk implantation: a new \u201cstandard\u201d therapy for type a dissection involving repair of the aortic arch?","volume":"123","author":"Sun","year":"2011","journal-title":"Circulation"},{"key":"2019103110093066700_ivz229-B3","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.ejvs.2018.12.011","article-title":"Current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the European Association For Cardio-Thoracic Surgery (EACTS) & the European Society For Vascular Surgery (ESVS)","volume":"57","author":"Czerny","year":"2019","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2019103110093066700_ivz229-B4","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1016\/j.jtcvs.2013.12.007","article-title":"Surgery for acute aortic dissection using the Chinese CRONUS stented elephant trunk technique: experience with 252 patients","volume":"148","author":"Wu","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2019103110093066700_ivz229-B5","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/ejcts\/ezv085","article-title":"Current status and recommendations for use of the frozen elephant trunk technique: a position paper by the Vascular Domain of EACTS","volume":"47","author":"Shrestha","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"2019103110093066700_ivz229-B6","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s11748-018-0911-4","article-title":"Is the frozen elephant trunk 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