Low-flow perfusion via the innominate artery during aortic arch operations provides only limited somatic circulatory support

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Olaf RoerickRobert Cesnjevar

Abstract

Aortic arch operations in pediatric patients using low-flow perfusion techniques have been standardized to a certain degree, but some of the often-stated beneficial effects have never been proven. Especially, the existence or efficacy of any subdiaphragmal perfusion still remains unclear. Twenty-six newborn male piglets (10-15 kg) underwent aortic arch surgery under general anesthesia using either low-flow perfusion via the innominate artery (LF, 30 ml/(kg min), 25 degrees C, n=12) or conventional deep hypothermic circulatory arrest (DHCA, 20 degrees C, n=14). Cortical somatosensory-evoked potentials (SSEPs), carotid, and subdiaphragmal blood flows were measured. The animals of both groups have been randomized to either pH-stat or alpha-stat management on cardiopulmonary bypass (CPB). During low-flow perfusion via the innominate artery only negligible flows of maximum 1-3 ml/min in the femoral arteries were detected, whereas the right carotid artery flow doubled. During reperfusion, serum-lactate and aspartate amino-transferase (AST) levels were significantly higher compared to the circulatory arrest group, whereas alanine amino-transferase (ALT), gamma-glutamyl transpeptidase (gamma-GT), AP, and creatinine did not show any sig...Continue Reading

Citations

Nov 1, 2008·Journal of Cardiothoracic Surgery·Takashi MiyamotoKuniyoshi Ohara
Apr 9, 2013·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Stephen M LangleyRabin Gerrah
Aug 30, 2011·The Annals of Thoracic Surgery·Alexandros N KaravasDavid P Bichell
Jun 28, 2011·The Annals of Thoracic Surgery·Mohamed LyAlain Serraf
Jul 5, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Igor A KornilovAlexander Y Omelchenko
May 4, 2018·Interactive Cardiovascular and Thoracic Surgery·Michaela KreuzerRudolf Mair

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