DOES STANDARD SURGICAL REPAIR OF DEBAKEY TYPE I DISSECTION ALTER TRUE LUMEN GEOMETRY DOWNSTREAM

two strategies in a contemporary cohort of patients undergoing partial aortic arch resection. METHODS: Sixty-three consecutive patients undergoing partial aortic arch resection were included. Patients were divided into deep hypothermia (DH, n 1⁄4 33) and mild hypothermia (MH, n 1⁄4 30) based on lowest cardiopulmonary bypass (CPB) temperature. Acute type A aortic dissections were excluded from this study. Antegrade cerebral perfusion was performed either through axillary artery cannulation or direct cannulation of arch vessels. Data on clinical outcomes and blood product use was obtained. The primary endpoint was a composite of mortality and major morbidity including stroke, need for dialysis, and deep sternal wound infection. RESULTS: The baseline characteristics including age, gender, LV function, renal function and prior sternotomies were similar between both groups. There were 22 elective cases, 9 urgent cases and 2 emergent cases in the DH group. In the MH group, there were 27 elective cases, 3 urgent cases and no emergent cases. The circulatory arrest time in the DH and MH groups were 32.7 20.4 min and 18.7 5.8 min respectively (p < 0.001). The lowest CPB temperature in the DH and MH groups were 19.5 2.8 C vs. 31.4 2.3 C respectively (p < 0.001). CPB times were significantly longer in DH patients (264 107 vs. 141 59 min, p < 0.001). The incidence of all major clinical adverse outcomes was higher in the DH group (see Table). The primary endpoint occurred in 42% of DH and 10% of MH patients (p 1⁄4 0.005). The proportion of patients requiring any blood products in the DH and MH groups was 97% vs. 47% (p < 0.001). The number of units of blood products needed was substantially higher in the DH group (see Table). CONCLUSION: In patients undergoing partial aortic arch resection, mild hypothermia with antegrade cerebral perfusion is associated with lower morbidity and decreased need for blood products compared to deep hypothermia. These findings require further validation in larger, prospective clinical trials.