title: Colder is better during hypothermic circulatory arrest for acute type A aortic dissection.
abstract: OBJECTIVE
  To evaluate the influence, on early postoperative outcomes, of temperature during hypothermic circulatory arrest in emergent surgery for acute type A aortic dissection.
  
  
  METHODS
  Hypothermic circulatory arrest (HCA) with antegrade cerebral perfusion was performed in 63 patients who underwent emergent surgery for acute type A aortic dissection between 2000 and 2009. Patients were retrospectively separated in two groups: ( 1 ) deep HCA, lowest nasopharyngeal temperature < 17 °C (n = 29; 46%) and ( 2 ) moderate HCA, lowest nasopharyngeal temperature ≥ 17 °C (n = 34; 54%).
  
  
  RESULTS
  Hospital mortality reached 27%. The nasopharyngeal temperature did not influence postoperative mortality or neurological outcome. Patients with deep HCA had significantly lower rate of infection (33% vs. 69%; p = 0.009) and shorter median intensive care unit length of stay (4 days ( 17 ) vs. 15.5 days ( 26 ) p = 0.017). Multiple regression analysis revealed that the lowest nasopharyngeal temperature was the only significant variable associated with intensive care unit length of stay (p = 0.005).
  
  
  CONCLUSIONS
  Patients suffering from acute type A aortic dissection might benefit from colder hypothermia during circulatory arrest.
authors.affiliation: Department of Cardiac Surgery, Assistance Publique-Hôpitaux de Paris, Henri Mondor Hospital, Créteil, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Legras
authors.forename: Matthieu
authors.initials: M
authors.lastname: Bruzzi
authors.forename: Kuniki
authors.initials: K
authors.lastname: Nakashima
authors.forename: Marie-Line
authors.initials: ML
authors.lastname: Hillion
authors.forename: Daniel
authors.initials: D
authors.lastname: Loisance
authors.forename: Matthias
authors.initials: M
authors.lastname: Kirsch
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome