title: Evolution of cerebral perfusion techniques in type a aortic dissection surgery: a single center experience.
abstract: BACKGROUND
  The purpose of this study was to investigate the effect of using antegrade selective cerebral perfusion (ASCP) with moderate hypothermia on hospital mortality after surgery for acute type A aortic dissection (AAAD).
  
  
  METHODS
  Between January 1998 and December 2008, 142 consecutive patients were operated on for AAAD. Patients were divided into two subgroups: the cohort of patients operated on from January 1998 until December 2003 (without ASCP) (P1998-2003, n=64) and the cohort operated on from January 2004 until December 2008 (with ASCP)(P2004-2008, n=78).
  
  
  RESULTS
  The difference in hospital mortality was statistically significant (P1998-2003: 42.2%; P2004-2008: 14.1%, p<0.0005). Survival rates were 51.6±6.2% vs. 75.1±5.5% and 45.9±6.2% vs. 69.7±7.3% for one and four years, respectively (p=0.001). Multivariate logistic regression analysis revealed that ASCP was the only independent protective factor of hospital mortality (p=0.047).
  
  
  CONCLUSIONS
  In patients operated on for AAAD, antegrade selective cerebral perfusion with moderate hypothermia is a significant factor in decreasing hospital mortality.
authors.affiliation: Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Salah
authors.forename: A H M
authors.initials: AH
authors.lastname: van Straten
authors.forename: M A
authors.initials: MA
authors.lastname: Soliman Hamad
authors.forename: J F
authors.initials: JF
authors.lastname: ter Woorst
authors.forename: M E S H
authors.initials: ME
authors.lastname: Tan
mesh_terms: D000784:Aortic Dissection / Q000601:surgery*; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome