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Preliminary results of single centre experience with the “release and perfuse technique” during aortic arch surgery.
  • Antonio Piperata
Antonio Piperata

Corresponding Author:a.piperata88@gmail.com

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Background and aim of the study To evaluate whether the release and perfuse technique implies a circulatory arrest time comparable with or shorter than those of standard Frozen Elephant Trunk technique in aortic arch surgery. Methods We retrospectively reviewed the records of patients who had undergone aortic arch repair with Release and Perfuse Technique (RPT) or standard Frozen Elephant Trunk (FET) at our Institution between January 2018 and May 2021. Primary endpoints were the comparison of circulatory arrest time, perioperative variables, and complications between two groups. A propensity score weighting approach was used for data analysis. Results A total of 41 patients underwent aortic arch surgery were analyzed:15 (37%) and 26 (63 %) in RPT and FET group, respectively. The use of RPT showed a significant shorter circulatory arrest times than FET: 9 min vs 58 min (P < 0.001), respectively. The median lactates peak in the first 24h post intervention was 2.6 for RPT group and 5.4 mmol/L for FET group, (P <0.0001). When compared with the FET, RPT is associated with significant reduction in the use of packed red blood cells (P <0.0001), fresh frozen plasma (P <0.0001), platelet concentrate (P <0.0001), and fibrinogen (P <0.004). The median ICU stay was 3 and 9 days (P = 0.011), whereas the median hospital stay was 12 and 18.5 days (P=0.004) in the RPT and FET groups, respectively. Thirty-day mortality and postoperative outcomes were comparable between the two groups. Conclusions Considering the anatomical limitations related to the use of this technique, the RPT appears to be safe, feasible, and effective in reducing the circulatory arrest time during aortic arch surgery. Nevertheless, further studies are required to demonstrate its safety and efficacy.