Antegrade Versus Retrograde Cerebral Perfusion in Aortic Surgery: Systematic Review and Meta-Analysis of 19365 Patients.
Early mortality, as well as cerebrovascular injury, are two of the
main concerns following ascending aorta and aortic arch surgery. It has been long debated whether method of brain protection strategy can play a role in mitigating the risk of morbidity and mortality.
Aortic surgery has many technical variations affecting
the outcomes, not only ACP vs RCP, and these variables are hard to control. However, it is still unclear whether perfusion strategies, per se, can be adequate to determine the outcome of aortic surgery.
While the key to success is the combination of optimal steps based upon
clinical circumstances, our meta-analysis attempts to determine if there is any measurable difference between ACP and RCP strategies to help surgeons in their decision-making process and support those adopting minimally invasive approaches.
We performed a systematic review with meta-analysis in order to strictly compare ACP vs RCP during ascending aorta and aortic arch surgery, by means of an internationally recognized protocol
for meta-analyses of observational studies in epidemiology the meta-analyses of observational studies in epidemiology.
The following databases were searched for articles meeting our inclusion criteria and published through March 2020: PubMed/Medical literature analysis and retrieval system online, Excerpta
Medica dataBASE, cochrane controlled trials register; ClinicalTrials.gov and Google Scholar. The related articles and additional references in identified articles were used to expand the search.
Surg Res Open J. 2022; 7(1): 1-11. doi: 10.17140/SROJ-7-128