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Retrograde Inferior Vena caval Perfusion for Total Aortic arch Replacement Surgery (RIVP-TARS): study protocol for a
Jing Lin1, Zhaoxia Tan1, Hao Yao2
1Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, Sichuan Province, China.
Trials
|April 25, 2019
Summary
Retrograde inferior vena caval perfusion (RIVP) combined with antegrade cerebral perfusion (ACP) may improve outcomes in total aortic arch replacement surgery (TARS) for acute type A aortic dissection by protecting lower body organs from ischemia.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Acute type A aortic dissection poses risks of visceral and spinal cord ischemia during total aortic arch replacement surgery (TARS), even with antegrade cerebral perfusion (ACP).
- Retrograde inferior vena caval perfusion (RIVP) is a potential adjunct to ACP to improve lower body oxygenation during TARS.
Purpose of the Study:
- To evaluate if combining RIVP with ACP offers superior outcomes compared to ACP alone in TARS for acute type A aortic dissection.
- To provide robust evidence for the clinical utility of RIVP in this patient population.
Main Methods:
- A multicenter, randomized controlled trial with 636 patients undergoing TARS.
- Patients randomized 1:1 to moderate hypothermia circulatory arrest (MHCA) with ACP or MHCA with combined RIVP and ACP.
- Primary outcome: composite of early mortality and major complications (paraplegia, renal failure, liver dysfunction, gastrointestinal issues).
Main Results:
- This section is not available in the provided abstract.
Conclusions:
- The study aims to determine the superiority of RIVP plus ACP over ACP alone during TARS.
- High-quality evidence is sought to support the use of RIVP in patients with acute type A aortic dissection undergoing TARS.
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