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Initial experience with cool head, warm body perfusion in aortic arch surgery
R Matsuwaka1, T Sakakibara, T Hori
1Division of Cardiovascular Surgery, Cardiovascular Center, Osaka Police Hospital, Japan.
Journal of Cardiac Surgery
|October 30, 1999
Summary
This study modified aortic arch surgery perfusion, using hypothermic cerebral perfusion with tepid visceral perfusion. This technique showed promising initial results, with low mortality and no strokes, enabling faster patient recovery.
Area of Science:
- Cardiovascular Surgery
- Cerebral Protection
- Aortic Arch Reconstruction
Background:
- Hypothermia is crucial for brain protection during aortic arch surgery.
- Adverse effects of hypothermia necessitate modified perfusion techniques.
- This study reviews initial outcomes of a novel perfusion strategy.
Purpose of the Study:
- To evaluate a modified perfusion technique in aortic arch surgery.
- To reduce adverse effects associated with hypothermia.
- To assess the safety and efficacy of simultaneous hypothermic cerebral and tepid visceral perfusion.
Main Methods:
- Nineteen patients with aortic aneurysms underwent surgery.
- Hypothermic antegrade selective cerebral perfusion (SCP) was performed (25-28°C).
- Simultaneous visceral perfusion used tepid or normothermia (34-36°C).
Main Results:
- Low hospital mortality rate of 5.3% (1/19).
- Zero postoperative stroke incidence in all 19 patients.
- Rapid recovery observed, with extubation at 9.4 hours and ICU stay of 3.0 days.
Conclusions:
- The modified technique combines hypothermic cerebral perfusion with tepid/normothermic visceral perfusion.
- This approach is a valuable adjunct for aortic arch surgery.
- The technique facilitates quicker patient recovery post-surgery.