[Cerebral protection with selective cold blood cerebral perfusion by gravity during aortic arch reconstruction].
Selective cold blood cerebral perfusion by gravity using specially designed reservoir with a built-in heat exchanger was applied to 30 consecutive patients who required aortic arch reconstruction. Rectal and brain temperature during cerebral perfusion were maintained at 22 degrees C and 16 degrees C respectively. Patients were divided into two groups according to postoperative condition of consciousness. Twenty three patients had uneventful recovery of consciousness (Group-1), and 7 patients showed delayed recovery or disturbance of consciousness (Group-2). Age, sex, causes of aneurysm, rectal temperature and conditions of cerebral perfusate were not statistically significant in both groups. Selective cerebral perfusion time in Group-1 was 68 +/- 36 min and 85 +/- 31 min in Group-2 (statistically not significant). Extracorporeal circulation time in Group-2 (243 +/- 61 min) was significantly longer than in Group-1 (187 +/- 56 min) (p < 0.05). Five of seven patients (71%) in Group-2 were in shock pre- or early post-operative period contrary to 0% in Group-1 (p < 0.001). These results suggest that selective cold blood cerebral perfusion protects effectively the brain during aortic arch reconstruction in the patients without hemodynamic deterioration.
Department of Surgery, Saitama Medical School, Japan.
Y
Y
Yokote
S
S
Kimura
S
S
Kyo
K
K
Hasegawa
K
K
Ueda
H
H
Asano
R
R
Omoto
H
H
Adachi
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001161:Arteriosclerosis / Q000601:surgery; D001769:Blood; D002315:Cardiopulmonary Bypass; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*