[Surgical outcome of aortic arch aneurysm in the institutes registered with Tokai Cardiovascular Surgeons Conference]

In aortic arch replacement, cerebral protection has been achieved by means of deep hypothermia associated with complete circulatory arrest, selective cerebral perfusion (SCP), or retrograde cerebral perfusion (RCP). We describe our results of the investigation with questionnaire to the institutes registered with the Tokai Cardiovascular Surgeons Conference in 1994. In 23 institute, surgical procedures of aortic arch were performed for 333 cases from 1989 to 1994, which were consisted of 126 cases of true atherosclerotic aneurysm and 206 cases of dissecting aneurysm. Cerebral disorders occurred in 11% (37/333). The incidence of cerebral disorders was significantly higher in patients with RCP methods (16%, 18/111), than SCP method (7%, 15/204, p < 0.05). In patients who had dissecting aneurysm, the incidence of cerebral disorders was 6% with SCP method (7/126) and 21% with RCP methods (14.66), respectively (p < 0.05). The cerebral disorders with RCP methods were most frequently caused by the malperfusion. In atherosclerotic cases, the causes of the cerebral disorders were mainly the embolic disorders.