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[Total arch replacement using prior selective cerebral perfusion].

M Imamaki1, M Masuda, A Ishida

  • 1Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 24, 2002
PubMed
Summary
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Prior selective cerebral perfusion effectively reduces cerebral embolization during aortic arch surgery. This technique, isolating cerebral circulation, showed promising results in a study of 27 patients undergoing aortic arch replacement.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Context:

  • Aortic arch aneurysms pose significant risks, including cerebral embolization.
  • Traditional surgical approaches can lead to complications from aortic manipulation.
  • Prior selective cerebral perfusion (SCP) offers a method to mitigate these risks.

Purpose:

  • To evaluate the efficacy and safety of prior selective cerebral perfusion in patients undergoing total aortic arch replacement.
  • To assess the incidence of neurological dysfunction and mortality associated with this technique.

Summary:

  • Twenty-seven patients with degenerative aortic arch aneurysms underwent total arch replacement using prior SCP.
  • The procedure involves simultaneous selective cerebral and systemic perfusion with aortic arch vessel clamping.

Related Experiment Videos

  • Key outcomes included surgical mortality (7.4%), in-hospital mortality (18.5%), and permanent neurologic dysfunction (3.7%).
  • Mean circulatory arrest time was 81.4 minutes, with SCP time at 194.9 minutes and extracorporeal circulation time at 280.6 minutes.

    • Impact:

    • Prior selective cerebral perfusion may be a valuable strategy for preventing cerebral embolization during complex aortic arch surgery.
    • The technique demonstrated a low rate of permanent neurologic dysfunction.
    • Long-term survival at 8 years was 73.3%, suggesting potential for improved patient outcomes.