[Single selective cerebral perfusion for aortic arch replacement]

The patients underwent aortic arch replacement for aneurysmal disease from 1988 to 1993 using a simplified cardiopulmonary bypass (CPB) technique with single selective cerebral perfusion (single SCP). Recently cold cerebral perfusion technique was also used. In order to study the effect of this technique, we monitored bilateral carotid artery pressure, blood oxygen saturation of jugular vein and brain oxygenation by near infrared spectroscopy during CPB. Of the ten patients with arch aneurysm, five had urgent operation for ruptured aneurysm. The cold single SCP was accomplished by perfusion to the right axillary artery using separate pump and separate heat exchanger (flow 10-15 ml/kg/min, pressure 40-60 mmHg, perfusion temperature under 12 degrees C) under the low CPB flow (1,000-1,500 ml/min), moderate systemic cooling (23-25 degrees C) and retro-grade cardioplegia. There were no strokes caused by this technique. This simplified technique of cold single SCP was simple and attractive method, provide satisfactory cerebral protection.