Cerebral death-like conditions after aortic aneurysm surgery using retrograde cerebral perfusion.
A patient with Stanford type A acute aortic dissection who developed severe cerebral dysfunction after surgery using retrograde cerebral perfusion through the superior vena cava was examined. The patient was able to regain normal brain function with no neurological deficit. Postoperative venography taken through the superior vena cava showed the presence of competent venous valves at the venous angles. This suggests that the valves interrupted cerebral perfusion, decreasing blood flow to less than that required. After consideration of the possible causes of brain damage incurred during surgery for aortic aneurysm using retrograde cerebral perfusion, it was concluded that this patient was able to recover normal brain function because the surgery was performed under profound hypothermia.
Tsuchida
K
K
Division of Cardiovascular Surgery, Hoshi General Hospital, Fukushima, Japan.
Hashimoto
A
A
Takazawa
A
A
Yamaki
F
F
Koyanagi
H
H
D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001921:Brain / Q000098:blood supply*; D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology; D001926:Brain Death / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D006801:Humans; D008297:Male; D010477:Perfusion / Q000379:methods*; D010690:Phlebography; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000503:physiopathology