Topic Tuesday: Deep Hypothermic Circulatory Arrest
- keyanazahiri
- 18 minutes ago
- 2 min read
Welcome back to topic Tuesday! To round out our discussion of aortic interventions this month, today we will be briefly discussing a rather complicated topic in cardiac surgery, deep hypothermic circulatory arrest.
If you or a loved one has been told that your upcoming heart or aortic surgery may involve deep hypothermic circulatory arrest, it’s normal to feel anxious and confused. The term sounds intimidating, but the technique is a well-established, carefully controlled method used to make complex aortic surgeries safer.
What is deep hypothermic circulatory arrest?
During some major aortic operations, your surgeon may need to temporarily stop blood flow to the aorta or the large branches that feed the brain in order to repair or replace diseased tissue. To protect your organs during this pause in blood flow, the surgical team cools your body down—usually to about 18–20°C. This deep cooling significantly slows your body’s metabolism, reducing the amount of oxygen your brain and other organs need. Essentially, your body is placed in a temporary “energy-saving mode” so surgical repair can be safely performed.
When is deep hypothermic circulatory arrest used?
Deep hypothermic circulatory arrest is most commonly used in aortic surgery, especially involving replacing or repairing a diseased aortic arch. A hemi arch repair involves repairing or replacing a portion of the aortic arch (typically the first portion closer to the heart itself) that is diseased from aneurysm or dissection. A total arch replacement is a more complex procedure that involves replacing the entirety of the aortic arch and reimplanting the major blood vessels supplying blood to the brain and arms. This procedure requires a longer and deeper hypothermic circulatory arrest than a hemi arch procedure. The circulatory arrest technique allows for the creation of a temporary bloodless and motionless field for surgeons to quickly and safely make necessary repairs.
Is deep hypothermic circulatory arrest safe?
Deep hypothermic circulatory arrest is a well established and studied technique that is routinely safely used by experienced cardiac surgery teams for aortic repairs. Lowering your body’s temperature significantly reduces your body’s oxygen demand giving surgeons a safe time window to stop circulation. Most periods of deep hypothermic circulatory arrest last under 30 minutes, which is within a safe range determined by decades of practice. Strategies such as retrograde or antegrade cerebral perfusion are often used to maintain some blood flow to the brain during the circulatory arrest to reduce the risk of neurologic complications. As with any major surgery, risks do exist with this technique, but your surgeons will weigh risks and benefits before offering this procedure.
That’s all for today! We hope this segment provides you with an overview of deep hypothermic circulatory arrest. Your healthcare team is always your best resource, so be sure to bring up any questions or concerns you may have with your cardiac surgery team. Staying informed is an important part of your care, and we’re here to support you every step of the way.
Have a happy and safe Thanksgiving!
Keyana Zahiri
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