Effect of season and cryopreservation on oxidative status of stallion spermatozoa

The aim of this study was to investigate 1) the effect of different ROS and lipid peroxidation on sperm quality, and 2) differences in ROS between non-breeding and breeding seasons. Eighteen ejaculates from six stallions were collected in January and July (N = 36), processed for freezing. After 90’ of cooling, some straws were not frozen (unfrozen), some were frozen (frozen). Rapid sperm (RAP, CASA), membrane-acrosome integrity (MAI), high mitochondrial membrane potential (Mpos), intracellular Ca2+ (Fneg), lipid peroxidation (BODIPY), ROS (DCFH, MitoSOX) and chromatin fragmentation (DFI%) were evaluated by flow cytometry during incubation at +37°C at T0 (after 90 min at +4°C and after thawing), 3, 6, 12 and 24h. In winter, ROS and BODIPY were higher and faster (P < 0.0001) in frozen than unfrozen; DFI% was similar at 0h (P > 0.05) but higher in frozen after 3h of incubation (P < 0.0001). RAP, PMAI, Mpos and Fneg were lower in frozen compared to unfrozen (P < 0.0001). Summer and winter data were compared. Overall, ROS concentrations and BODIPY were higher and faster (P < 0.001) in winter, DFI% was lower in winter (P < 0.001), but similar between the two groups within seasons after thawing. Differences were found at 3h and 12h for DFI%, and for DCFH and MitoSOX at 0h and 12h of incubation in winter and summer respectively. A moderate positive correlations was found between DFI% and MitoSOX, DCFH, BODIPY, whereas a negative correlation, stronger in winter, between RAP, PMAI, Mpos, Fneg and BODIPY, DCFH, MitoSOX. DFI was not different in unfrozen and frozen, despite a significant higher ROS level in winter, and incubation allowed to asses differences in DFI, suggesting that incubation should be included when evaluating stallion frozen semen. Higher level of ROS and BODIPY in winter was less detrimental than freezing-thawing.

The frozen elephant trunk technique for the treatment of complex aortic arch and descending thoracic aorta pathologies: long term outcomes and distal reintervention

Background: The frozen elephant trunk(FET) technique is one of the last evolution in the treatment of complex pathologies of the aortic arch and the descending thoracic aorta.Materials and methods: Between January 2007 and March 2021, a total of 396 patients underwent total aortic arch replacements with the FET technique in our centre.The main indications were thoracic aortic aneurysm(n=104,28.2%), chronic aortic dissection(n=224,53.4%) and acute aortic dissection(n=68, 18.4%). We divided the population in two groups according the position of the distal anastomosis (zone 2 vs zone 3) and the length of the stent graft (< 150 mm vs > 150 mm): conservative group (Zone 2 anastomosis + stent length < 150mm, n. 140 pts) and aggressive group (zone 3 anastomosis + stent length > 150mm, n. 141). Results: The overall 30-day mortality rate was 13%(48/369); the risk factor analysis showed that an aggressive approach was neither a risk factor for major complication (permanent dialysis, tracheostomy, bowel malperfusion and permanent paraplegia) neither for 30-day mortality. The survival rate at 1, 5,10 and 15 years was 87.7%,75%,61.3% and 58.4% respectively. During the follow up, an aortic reintervention was performed in 122 patients (38%), 5 patients received a non-aortic cardiac surgery. Freedom from aortic reintervention at 1-,5- and 10-year was 77%,54% and 44% respectively. The freedom from aortic reintervention was higher in the ‘aggressive’ group (62.5%vs40.0% at 5 years, log-rank=0.056). An aggressive approach was not protective for aortic reintervention at follow up and for death at follow up. Conclusions: The FET technique represents a feasible and efficient option in the treatment of complex thoracic aortic pathologies. An aortic reintervention after FET is very common and the decision-making approach should consider and balance the higher risk of an aggressive approach in terms of post-operative complication versus the higher risk of a second aortic reintervention at follow-up.