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Meta-analysis of the effects of anterograde and retrograde cerebral perfusion in aortic arch surgery / 中华胸心血管外科杂志
Chinese Journal of Thoracic and Cardiovascular Surgery ; (12): 546-550, 2019.
Article in Chinese | WPRIM | ID: wpr-756398
ABSTRACT
Objective To explore the differences in brain protection between anterograde cerebral perfusion( ACP) and retrograde cerebral perfusion( RCP) in aortic arch surgery. Methods Aortic arch circulatory surgery, ACP and RCP tech-niques were searched at the Cochrane Library, PubMed, EMBASE, Wanfang Database and the Chinese Biomedical Database from January 2013 to December 2018. Cohort studies were then performed with early postoperative death, transient neurological dysfunction(TND), stroke, and transient ischemic attack(TIA). For each study, data on endpoints in the ACP and RCP groups were used to generate risk ratios( RR) and 95% confidence intervals( CI) . The funnel chart was used to test publication bias. Results A total of 6692 patients were enrolled in 12 studies, of which 3902 patients received low-temperature circula-tory arrest plus ACP, and 2790 patients received low-temperature circulatory arrest plus RCP. Summary analysis showed that the early postoperative death(RR=0. 83, 95%CI=0. 51-1. 35,P=0. 46), stroke(RR=1. 09, 95%CI=0. 91-1. 31, P=0.33),transient neurological dysfunction(RR=0.81, 95%CI=0.17-3.91,P=0.80) and transient ischemic attack(RR=1.00,95%CI=0.74-1.34,P=1.00) in both groups were no significant differences(all P>0.05). Conclusion There are no significant differences in postoperative mortality and neurological dysfunction between antegrade cerebral perfusion and retrograde cerebral perfusion in the aortic arch surgery. Combined with hypothermic circulatory arrest, it can be selected ac-cording to the actual situation of aortic arch surgery.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Systematic reviews Language: Chinese Journal: Chinese Journal of Thoracic and Cardiovascular Surgery Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Systematic reviews Language: Chinese Journal: Chinese Journal of Thoracic and Cardiovascular Surgery Year: 2019 Type: Article