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[Partial brachiocephalic perfusion in aortic arch replacement]

H Akashi1, S Aoyagi, Y Kubota

  • 1Second Department of Surgery, Kurume University School of Medicine, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 1, 1993
PubMed
Summary
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Partial brachiocephalic perfusion (PBP) offers safe cerebral protection during aortic arch surgery. This simplified hypothermic method demonstrated reliability in preventing neurological complications in patients with aortic aneurysms.

Area of Science:

  • Cardiovascular Surgery
  • Cerebral Protection Strategies
  • Aortic Arch Reconstruction

Context:

  • Aneurysm and dissection of the aortic arch pose significant surgical challenges.
  • Maintaining adequate cerebral perfusion during aortic arch surgery is critical.
  • Current methods for cerebral protection can be complex.

Purpose:

  • To evaluate the safety and efficacy of partial brachiocephalic perfusion (PBP) for cerebral protection during aortic arch surgery.
  • To assess neurological outcomes in patients undergoing aortic arch replacement with PBP.
  • To investigate the physiological parameters during PBP, including cerebral circulatory index (CCI) and jugular vein oxygen saturation (SjO2).

Summary:

  • Twenty patients with aortic arch aneurysm or dissection underwent surgery using a simplified partial brachiocephalic perfusion (PBP) technique under hypothermic cardiopulmonary bypass (CPB).

Related Experiment Videos

  • The PBP involved separate cannulation and perfusion of the right subclavian artery and common femoral artery.
  • Neurological complications were observed in only one of the 19 patients, suggesting a high safety profile.

    • Impact:

    • Partial brachiocephalic perfusion (PBP) under hypothermic cardiopulmonary bypass (CPB) appears to be a safe and effective method for cerebral protection.
    • This simplified PBP technique may reduce the risk of neurological complications in patients undergoing aortic arch replacement.
    • The study supports PBP as a reliable approach for safeguarding cerebral circulation during complex aortic arch surgeries.