Operative details
The involved supra-aortic branch vessels were shown in Figure 2. All patients underwent median sternotomy with total cardiopulmonary bypass and surgical repair of ascending aorta with or without proximal aortic root repair. The arch repair depended on the tear location. 118 (38.4%,118/307)patients underwent hemiarch replacement (HAR), 86 (28%,86/307) underwent total arch replacement (TAR), and 50(16.3% 50/307) underwent partial arch replacement (PAR). Two studies reported the additional procedure extra-anatomic aorto-carotid bypass for impaired CCA (n = 32). The femoral or right axillary arteries or both were the most frequent choices for arterial cannulation. The additional arterial inflow included ascending aorta (n = 22), carotid artery (n = 11), innominate artery (n = 6), cardiac apex (n = 1). Antegrade (unilateral or bilateral) and/or retrograde cerebral perfusion were (was) recorded as brain protection during surgery in ten reports including 214 patients. Of these patients, 152 (71%) underwent ACP, 67 (31.3%) underwent RCP. The mean target core temperature during hypothermic cardiac arrest was 22.7 ± 3.3 (15 - 29.3)℃, and the mean hypothermic cardiac arrest time was 41.9 ± 16.7 (18-77) minutes in 91 patients. The mean cross-clamp time and CPB time was 131± 45.4 and 213.9 ± 73.8 minutes respectively. The details of operative procedures were summarized in table 3.