1. Two different techniques of retrograde cerebral perfusion for thoracic aortic surgery through a left thoracotomy
- Author
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Hitoshi Ogino, Takaaki Sugita, Keiji Matsubayashi, T Nomoto, Ueda Y, and Yutaka Sakakibara
- Subjects
Male ,Aortic arch ,medicine.medical_specialty ,medicine.medical_treatment ,law.invention ,Hypothermia, Induced ,law ,Internal medicine ,medicine.artery ,medicine ,Cardiopulmonary bypass ,Embolism, Air ,Humans ,Radiology, Nuclear Medicine and imaging ,Thoracotomy ,Cerebral perfusion pressure ,Aged ,Cardiopulmonary Bypass ,Aortic Aneurysm, Thoracic ,business.industry ,Cerebral Infarction ,Venous blood ,Oxygen ,Perfusion ,Treatment Outcome ,Cerebrovascular Circulation ,Descending aorta ,Anesthesia ,Circulatory system ,Heart Arrest, Induced ,Cardiology ,Female ,Surgery ,Nervous System Diseases ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
The authors used profound hypothermic circulatory arrest and continuous retrograde cerebral perfusion for aortic surgery that involved the distal arch through a left thoracotomy. For the first seven patients, oxygenated blood from cardiopulmonary bypass was perfused retrogradely through a venous cannula positioned into the right atrium. In the last 11 cases, venous blood, provided by a perfusion from the lower body, was circulated passively in the brain with the descending aorta clamped. The period of profound hypothermic circulatory arrest was 34.6±11.1 min, and continuous retrograde cerebral perfusion was 31.3±11.1 min. Seventeen patients survived, but there was one early death. Two patients with a severely atherosclerotic aneurysm developed permanent neurological dysfunction. The combination of profound hypothermic circulatory arrest, continuous retrograde cerebral perfusion and open aortic anastomosis through a left thoracotomy protects the brain adequately, and facilitates evacuation of debris and air in the aortic arch. It produces satisfactory results for aortic surgery that involves the distal arch.
- Published
- 2000
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