title: Quick proximal arch replacement with moderate hypothermic circulatory arrest.
abstract: BACKGROUND
  The aim of this study is to evaluate the safety of proximal arch repair using only moderate hypothermic circulatory arrest (HCA) at a temperature of 25 degrees C to 28 degrees C without any adjunctive cerebral protection in comparison with those with moderate HCA and selective cerebral perfusion.
  
  
  METHODS
  Thirty patients who underwent proximal arch repair using moderate HCA without selective cerebral perfusion (SCP) were retrospectively examined and defined as the SCP (-) group. As a control group, 31 patients who underwent moderate HCA and SCP within 10 minutes were included in this study and defined as the SCP (+) group.
  
  
  RESULTS
  Mean circulatory arrest time was 9.4 +/- 0.8 minutes and 7.5 +/- 1.8 minutes (p = 0.0001) and mean nasopharyngeal temperature at the induction of the circulatory arrest was 26.0 +/- 1.2 degrees C and 26.8 +/- 1.3 degrees C (p = 0.014) in the SCP (+) group and SCP (-) group, respectively. Operative mortality was 3.2% in the SCP (+) group and 3.3% in the SCP (-), and neurologic complications were found in three (9.7%) patients in the SCP (+) group and two (6.7%) patients in the SCP (-) group (p = 0.69).
  
  
  CONCLUSIONS
  It was possible to perform proximal arch replacement in selected patients using moderate HCA without any adjunctive cerebral protection with excellent results, and no advantage of the use of SCP was found in patients who required short HCA for proximal arch replacement.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany. hiroyuki.kamiya@med.uni-heidelberg.de
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Christian
authors.initials: C
authors.lastname: Hagl
authors.forename: Irina
authors.initials: I
authors.lastname: Kropivnitskaya
authors.forename: Juergen
authors.initials: J
authors.lastname: Weidemann
authors.forename: Klaus
authors.initials: K
authors.lastname: Kallenbach
authors.forename: Nawid
authors.initials: N
authors.lastname: Khaladj
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D001831:Body Temperature; D001921:Brain / Q000098:blood supply; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000503:physiopathology; D009422:Nervous System Diseases / Q000209:etiology; D010477:Perfusion / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality