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[Retrograde cerebral perfusion with circulator arrest for aortic arch aneurysm]
1Department of Surgery, Kobe University School of Medicine, Kobe, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 1, 1993
Summary
Retrograde cerebral perfusion with deep hypothermia is a simple and effective method for aortic arch aneurysm surgery. This technique prevents cerebral embolization and yields good operative fields, improving patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Neurosurgery
- Vascular Surgery
Context:
- Aortic arch aneurysms pose significant surgical challenges.
- Deep hypothermia and circulatory arrest are often employed.
- Maintaining cerebral protection during aortic arch surgery is critical.
Purpose:
- To evaluate the safety and efficacy of retrograde cerebral perfusion (RCP) in aortic arch aneurysm repair.
- To assess the impact of RCP on cerebral protection and operative conditions.
- To report outcomes in patients undergoing aortic arch aneurysm surgery with RCP.
Summary:
- Thirteen patients with aortic arch aneurysms underwent surgery using deep hypothermia and RCP.
- RCP was initiated at a rectal temperature of 20°C via SVC cannula at 200-300 ml/min.
- Neuroprotective agents and a radical scavenger were administered during RCP, which lasted an average of 42.8 minutes.
- The technique prevented cerebral embolization and provided a clear operative field without aortic cannulation.
- Ten out of thirteen patients survived with complete recovery of consciousness; mortality was associated with myocardial infarction and renal failure.
Impact:
- Retrograde cerebral perfusion is a simple and useful technique for aortic arch aneurysm operations.
- This method enhances cerebral protection during complex aortic arch surgeries.
- The study demonstrates favorable outcomes and reduced complications with RCP in this patient cohort.