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Updated: Jun 24, 2026
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Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
[Thoracic aortic surgery with circulatory arrest and cold cerebral perfusion]
N Khaladj1, C Hagl, M Shrestha
1Klinik für Herz-, Thorax, Transplantations- und Gefässchirurgie, Medizinische Hochschule, 30625 Hannover. Khaladj.Nawid@mh-hannover.de
Summary
This study identified risk factors for mortality and neurological dysfunction in patients undergoing aortic arch surgery with hypothermic circulatory arrest (HCA) and selective antegrade cerebral perfusion (SACP). Age, repeat surgery, and bypass duration were key mortality predictors, while PND linked to renal issues and TND to CAD.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Anesthesiology
Context:
- Aortic arch surgery using moderate hypothermic circulatory arrest (HCA) and selective antegrade cerebral perfusion (SACP) is a complex procedure.
- Identifying pre- and perioperative risk factors is crucial for improving patient outcomes.
Purpose:
- To identify pre- and perioperative risk factors associated with mortality, permanent neurological dysfunction (PND), and temporary neurological dysfunction (TND).
- To evaluate outcomes in a large cohort of patients undergoing elective aortic arch surgery with HCA and SACP.
Summary:
- The study analyzed 319 patients undergoing elective aortic arch surgery with HCA and SACP.
- Overall mortality was 7.8%. Risk factors for mortality included age, repeat surgery, preoperative neurological events, coronary artery disease (CAD), and cardiopulmonary bypass duration.
- Permanent neurological dysfunction (PND) was associated with preoperative renal insufficiency and operation duration, while temporary neurological dysfunction (TND) was linked to CAD and prolonged bypass duration.
Impact:
- Findings highlight that while elective aortic arch surgery with HCA and SACP can yield excellent results, particularly in non-repeat cases, neurological complications are associated with significant hospital mortality.
- Neurological complications appear strongly linked to systemic atherosclerotic disease and surgical extent.
- This research provides valuable insights for risk stratification and patient management in complex aortic arch surgeries.
