PMID: 9160364Mar 1, 1997Paper

Intermittent antegrade/selective cerebral perfusion during circulatory arrest for repair of the aortic arch

Perfusion
C MaasM M Haalebos

Abstract

If the aortic arch requires repair or replacement due to an aneurysm or dissection, conventional cardiopulmonary bypass (CPB) is not possible during the period in which the aortic arch is excluded from the circulation. This creates a situation in which there is no cerebral circulation. The brain needs adequate protection from this ischaemic insult. Hypothermic circulatory arrest (HCA), antegrade/selective cerebral perfusion (ASCP) and retrograde cerebral perfusion (RCP) are reported to exhibit their cerebral protective capabilities during procedures involving the aortic arch. HCA can provide adequate protection in procedures of short duration and avoids the complications associated with cerebral perfusion techniques. The main disadvantage of HCA is that the 'safe' duration of circulatory arrest is not clearly defined. Topical cooling of the head may enhance cerebral hypothermia and provide additional protection. If longer periods of circulatory arrest are anticipated or occur unexpectedly, we suggest that ASCP can offer improved cerebral protection by providing adequate brain perfusion and improved cerebral cooling. By using a coronary sinus perfusion catheter as a carotid artery cannula, it is not necessary to snare or clamp t...Continue Reading

References

Jun 1, 1991·The Annals of Thoracic Surgery·M D CrittendenJ A Swain
Dec 1, 1993·The Annals of Thoracic Surgery·J A SwainM G Siegman
Jan 1, 1996·Journal of Cardiothoracic and Vascular Anesthesia·C O'DwyerW E Johnston
Jan 1, 1996·Journal of Cardiothoracic and Vascular Anesthesia·S Chanyi
Jan 1, 1995·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·K FukaeH Yasui

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