Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions

Area of Science:

• Cardiovascular Surgery
• Neurology
• Medical Technology

Background:

• Selective antegrade cerebral perfusion (SACP) is a critical technique for cerebral protection during aortic arch surgery.
• Understanding factors influencing neurological outcomes post-SACP is vital for patient safety.

Purpose of the Study:

• To investigate the correlation between SACP flow rates and the incidence of transient neurological dysfunction (TND) after aortic arch surgery.
• To identify potential risk factors for TND in patients undergoing SACP.

Main Methods:

• Retrospective analysis of 160 patients who underwent elective aortic arch replacement with SACP between January 2015 and May 2020.
• Collected and analyzed intra-operative SACP perfusion flow data.
• Utilized univariate and multivariate analyses to identify risk factors for TND.

Main Results:

• A significantly lower indexed medium perfusion flow of SACP was observed in patients who developed TND (11.63 ± 2.41 ml/kg/min) compared to those without (12.62 ± 2.39 ml/kg/min; P=0.03).
• Female gender was identified as an independent predictor of TND (P=0.004, OR=4.816).

Conclusions:

• Preliminary findings suggest a potential association between reduced SACP flow and an increased risk of TND.
• Further research with larger cohorts is warranted to validate these findings and refine SACP management strategies.