Related Experiment Video
Updated: May 28, 2026
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
A Comprehensive Total Body Perfusion Strategy vs Conventional Techniques in Elective Aortic Arch Surgery: A
Annesimone Lotfalla1,2, Samuel Heuts1,2, Rick Scheurs1,2
1Department of Cardiothoracic Surgery, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, Maastricht 6229 HX, The Netherlands.
Summary
Total body perfusion (TBP) offers a safe and effective alternative for aortic arch surgery, reducing ischemia-reperfusion injury and improving patient survival. This innovative approach enhances organ protection and may expand surgical options for high-risk individuals.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Aortic arch surgery traditionally involves hypothermic circulatory arrest, leading to ischemia-reperfusion injury in vital organs.
- Developing strategies to mitigate organ damage during aortic arch reconstruction is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the clinical outcomes of patients undergoing elective aortic arch replacement using a novel total body perfusion (TBP) strategy versus conventional techniques.
- To evaluate the safety and efficacy of TBP in providing continuous organ perfusion during complex aortic arch surgeries.
Main Methods:
- A comparative analysis of 121 patients undergoing elective aortic arch replacement between 2014 and 2025.
- Thirty-eight patients received TBP (continuous warm myocardial, selective cerebral, and retrograde visceral perfusion), while 83 patients underwent conventional techniques.
- Outcomes assessed included intraoperative parameters, biochemical markers, and clinical endpoints such as intensive care unit (ICU) stay and one-year survival.
Main Results:
- TBP significantly reduced myocardial ischemia time (65.0 vs 122.0 minutes) and circulatory arrest use (18.4% vs 86.7%).
- TBP patients exhibited lower peak lactate levels (2.2 vs 3.9 mmol/L) and shorter ICU stays (2.0 vs 4.0 days).
- One-year survival was significantly improved in the TBP group (92.1% vs 72.3%), with multivariable analysis confirming TBP's independent survival benefit.
Conclusions:
- Total body perfusion is a feasible and safe approach for elective aortic arch surgery, providing comprehensive organ protection.
- TBP is associated with improved clinical outcomes, including reduced ischemia time, shorter ICU stays, and enhanced survival rates.
- The TBP strategy holds potential for expanding surgical candidacy among high-risk patients requiring aortic arch reconstruction.
