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Hypothermic circulatory arrest for aortic dissection with cryoglobulinemia
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  • Kazuhiro Yamazaki,
  • Kenji Minatoya,
  • Kazuhisa Sakamoto,
  • Koji Kitagori,
  • Masanori Okuda,
  • Hideo Kanemitsu,
  • Takahide Takeda,
  • Masahide Kawatou,
  • Jiro Sakai,
  • Motoyuki Kumagai,
  • Takashi Tsuji,
  • Kosaku Murakami,
  • Tsuneyasu Yoshida,
  • Yujiro Ide,
  • Tadashi Ikeda
Kazuhiro Yamazaki
Graduate School of Medicine, Kyoto University
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Kenji Minatoya
Natl Cerebral
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Kazuhisa Sakamoto
Graduate School of Medicine, Kyoto University
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Koji Kitagori
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Masanori Okuda
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Hideo Kanemitsu
Graduate School of Medicine, Kyoto University
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Takahide Takeda
Graduate School of Medicine, Kyoto University
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Masahide Kawatou
Graduate School of Medicine, Kyoto University
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Jiro Sakai
Graduate School of Medicine, Kyoto University
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Motoyuki Kumagai
Kyoto University Graduate School of Medicine Department of Cardiovascular Surgery
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Takashi Tsuji
Graduate School of Medicine, Kyoto University
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Kosaku Murakami
Graduate of School of Medicine, Kyoto University
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Tsuneyasu Yoshida
Graduate of School of Medicine, Kyoto University
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Yujiro Ide
Graduate School of Medicine, Kyoto University
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Tadashi Ikeda
Graduate School of Medicine, Kyoto University
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Abstract

Cryoglobulinemia is a cold-reactive autoimmune disease. A 64-year-old man with active cryoglobulinemia presented Stanford type A acute aortic dissection. He had been treated with immunosuppressive drugs and plasma exchange (PE) at our hospital; subsequently, qualitative analysis of cryogobulin (CG) was negative. He underwent emergency ascending aorta replacement using cardiopulmonary bypass (CPB) under deep hypothermia circulatory arrest with selective cerebral perfusion. The total CPB time, aortic cross clamp time, and selective cerebral perfusion time were 255, 153, 56 minutes, respectively, and the minimal nasopharyngeal temperature was 17.3°C. Our patient had no significant perioperative complications. Hence, if PE is performed appropriately and CG is negative, patients with cryoglobulinemia who exhibit severe preoperative symptoms can safely undergo surgery with deep hypothermia.

Peer review status:Published

12 Jun 2020Submitted to Journal of Cardiac Surgery
12 Jun 2020Submission Checks Completed
12 Jun 2020Assigned to Editor
12 Jun 2020Reviewer(s) Assigned
18 Jun 2020Review(s) Completed, Editorial Evaluation Pending
22 Jun 2020Editorial Decision: Revise Major
09 Jul 20201st Revision Received
10 Jul 2020Submission Checks Completed
10 Jul 2020Assigned to Editor
10 Jul 2020Reviewer(s) Assigned
20 Jul 2020Review(s) Completed, Editorial Evaluation Pending
20 Jul 2020Editorial Decision: Accept
28 Jul 2020Published in Journal of Cardiac Surgery. 10.1111/jocs.14908