[Clinical experience of continuous retrograde cerebral perfusion for assisted circulation during the surgical treatment of acute dissection of aorta: Stanford A type].
Surgical treatment of the dissection involving the ascending aorta or aortic arch represents one of the most complicated technical challenges. Recently continuous retrograde cerebral perfusion (CRCP) is sometimes applied in order to avoid cerebral complications. We compared two surgical groups, one of which was performed graft-replacement of ascending aorta using CRCP and another was utilized normograde cerebral circulation, about the technique of operation, total extracorporeal circulation (ECC) time, aortic clamp time, separate ECC time, total bleeding volume, and urination during operation. In the group using CRCP, separate ECC time was 53 min (mean), and intraoperative bleeding volume was only 1,170 ml. Good urination was obtained during operation. Postoperative courses were uneventful, and consciousness was smoothly and soon recovered. The new method of separate ECC has some advantages over the previously described methods, particularly for avoidance of cerebral complications. As it is not necessary to require dissecting, taping, and clamping of cephalic branches, operative procedure will be very simplified, easier and safer, leading to intraoperative bleeding is a fewer. It is our belief that this method should be widely applied in the operation of graft-replacement of ascending aorta or aortic arch in the near future.
Nakano
H
H
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital.
Shimakura
T
T
Ihashi
K
K
Sakamoto
T
T
Hoshino
K
K
Takeda
M
M
Maejima
F
F
Mitani
M
M
Taguchi
A
A
Ichikawa
Y
Y
D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000601:surgery*; D001243:Assisted Circulation; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion