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Updated: Jul 15, 2025

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion

Published on: December 10, 2020

Retrograde Cerebral Perfusion May Decrease Stroke Risk During Elective Aortic Arch Surgery.

William B Keeling¹, David Tian², Woodrow Farrington¹

¹Division of Cardiothoracic Surgery, Emory University, Atlanta, GA, USA.

Innovations (Philadelphia, Pa.)

|September 27, 2023

Summary

This summary is machine-generated.

Comparing cerebral protection methods for hemiarch replacement (HEMI), deep hypothermia with retrograde cerebral perfusion (DHCA/RCP) showed fewer neurologic deficits than moderate hypothermia with antegrade cerebral perfusion (MHCA/ACP). Both strategies offer excellent neuroprotection with low mortality.

Keywords:

aorta circulatory arrest hemiarch

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Published on: February 17, 2013

Area of Science:

Cardiovascular Surgery
Neurology
Anesthesiology

Background:

Optimal neuroprotection during elective hemiarch replacement (HEMI) remains debated.
Two primary methods, moderate hypothermia with antegrade cerebral perfusion (MHCA/ACP) and deep hypothermia with retrograde cerebral perfusion (DHCA/RCP), are commonly employed.

Purpose of the Study:

To compare patient outcomes following HEMI using MHCA/ACP versus DHCA/RCP.
To evaluate the efficacy of these neuroprotection strategies in reducing adverse events.

Main Methods:

Analysis of 782 patients undergoing elective HEMI with circulatory arrest from the ARCH international aortic database (2007-2012).
Comparison of 418 patients in the MHCA/ACP group with 364 patients in the DHCA/RCP group.
Statistical analysis using univariable and multivariable models to assess outcomes.

Main Results:

The DHCA/RCP group had a lower incidence of permanent neurologic deficits (1.0% vs 3.9%, P=0.02).
Overall mortality was similar between groups (2.3% vs 3.4%, P=0.47).
Multivariable analysis revealed no significant differences in mortality or perioperative stroke between the two perfusion strategies.

Conclusions:

Both MHCA/ACP and DHCA/RCP are effective neuroprotective strategies for elective HEMI, associated with low mortality.
DHCA/RCP may offer a theoretical advantage in neurologic outcomes, warranting further investigation.