CONCLUSION
In the present network meta-analysis, the risk of operative mortality
decreased with the use of mild HCA. Furthermore, the use of DHCA was
associated with substantial higher risks of postoperative incidence of
stroke when compared with the application of moderate-to-mild
hypothermia management in combination with selective cerebral perfusion.
These outcomes were reinforced by the sensitivity analysis of RCTs and
PSM studies. Our findings call attention to and further highlight the
unique challenges in selecting and managing temperature in aortic arch
surgery. Future prospective high-quality research studies are warranted
to allow better outcomes in this complex surgical procedures.