OBJECTIVE: We examined the early outcomes and the long-term survival associated with different degrees of @entity2332 in @entity1 who received antegrade cerebral perfusion (ACP) for >30  minutes. METHODS: During a 10-year period, 544 consecutive @entity1 underwent proximal and total aortic arch surgery and received ACP for >30  minutes and 1 of 3 levels of @entity2332 : deep (14.1  C-20  C; n  =  116 [21.3%]), low-moderate (20.1  @entity4049 .9  C; n  =  262 [48.2%]), and high-moderate (24  C-28  C; n  =  166 [30.5%]). A variable called "predicted temperature" was used in propensity-score analysis. Multivariate analysis was done to evaluate the effect of actual temperature on outcomes. RESULTS: The operative mortality rate was 12.5% (n  =  68) overall and was 15.5%, 11.8%, and 11.5% in the deep, low-moderate, and high-moderate @entity2332 @entity1 , respectively (P  =  .54). The persistent @entity64 rate was 6.6% overall and 12.2%, 4.6%, and 6.0% in these 3 groups, respectively (P  =  .024 on univariate analysis). On multivariate analysis, actual temperature was not associated with mortality, but lower temperatures predicted persistent @entity64 and reoperation for @entity548 . In the propensity-matched subgroups, the @entity1 with predicted @entity2332 had (nonsignificantly) greater rates of persistent @entity64 (12.2% vs 4.9%; relative risk, 1.08; 95% CI, 0.87-1.15) and reoperation for @entity548 (14.6% vs 2.4%; relative risk, 1.14; 95% CI, 0.87-1.15) than the @entity1 with predicted moderate @entity2332 . On long-term follow-up (mean duration, 5.12  years), 4- and 8-year survival rates were 62.3% and 55.7% in the @entity2332 group and 75.4% and 74.2% in the moderate @entity2332 group (P  =  .0015). CONCLUSIONS: In proximal and arch operations involving ACP for >30  minutes, greater actual temperatures were associated with @entity64 and reoperation for @entity548 . There were no significant differences among the predicted @entity2332 levels, although a trend toward a higher rate of adverse events was noticed in the @entity2332 group. Long-term survival was better in the moderate @entity2332 group.

The impact of temperature in aortic arch surgery XXXX receiving antegrade cerebral perfusion for >30  minutes: How relevant is it really?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['less stroke', 'stroke'] @entity4049 :: ('4691', 'Gene') :: ['C-23'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity2332 :: ('MESH:D007035', 'Disease') :: ['deep hypothermia', 'hypothermia']
@entity1 :: (9606,Species) :: ['patients']
