Gen Thorac Cardiovasc Surg. 2026 May 18. doi: 10.1007/s11748-026-02312-9. Online ahead of print.
ABSTRACT
OBJECTIVE: Gastrointestinal complications and acute pancreatitis after cardiac surgery are relatively rare; however, they may sometimes progress to serious conditions and can be challenging to manage. We aimed to investigate the association between lower-body circulatory arrest (LCA) time under mild-to-moderate hypothermia with antegrade selective cerebral perfusion (ASCP) and postoperative visceral complications in patients undergoing thoracic aortic surgery.
METHODS: We retrospectively analyzed 221 patients who underwent thoracic aortic surgery for degenerative aneurysms involving the ascending aorta and aortic arch with LCA under mild-to-moderate hypothermia between 2015 and 2025. The associations between LCA time and postoperative complications, including gastrointestinal complications and pancreatitis, were evaluated using logistic regression analyses.
RESULTS: Prolonged LCA time was significantly associated with an increased incidence of postoperative gastrointestinal (P = 0.006) and lung complications (P = 0.02) in logistic regression models adjusted for minimal temperature. A similar trend was observed for AKI without statistical significance (P = 0.08). In contrast, acute pancreatitis was not associated with LCA time. Within the studied temperature range, minimal temperature was not significantly associated with visceral complications.
CONCLUSIONS: Prolonged LCA time under mild-to-moderate hypothermia using ASCP was significantly associated with increased postoperative gastrointestinal and lung complications, whereas pancreatitis was not associated. The duration of lower-body ischemia may be an important determinant of visceral organ injury within the studied temperature range.
PMID:42151699 | DOI:10.1007/s11748-026-02312-9
