[Partial brachiocephalic perfusion in aortic arch replacement].
Twenty patients with aneurysm or dissection of the aortic arch underwent surgical treatment using partial brachiocephalic perfusion (PBP). The right subclavian artery (SA) and common femoral artery were separately cannulated and perfused by individual pump heads. The flow to SA was 4.5-11 (9.9 +/- 1.4) ml/min/kg. The mean distal stump pressure of the left superficial temporal arteries before beginning the CPB were 36-64 (50.6 +/- 8.3) mmHg. The rectal temperature during PBP was maintained at 20.1-25.0 degrees C. The PBP time ranged 32 to 157 min. We studied the oxygen saturation of left internal jugular vein (SjO2) and cerebral circulatory index (CCI) during the PBP. SjO2 ranged from 72.9 to 99.4% and CCI were maintained at more than twice the CCI measured before beginning the CPB. We applied this simplified method (PBP) to the 20 patients with aortic aneurysms. No neurological complication were seen in these 19 patients without one patient. These clinical studies suggest that the PBP under hypothermic CPB is a safe and reliable method of cerebral protection for replacement of the aortic arch.
Second Department of Surgery, Kurume University School of Medicine, Japan.
H
H
Akashi
S
S
Aoyagi
Y
Y
Kubota
M
M
Momosaki
K
K
Yamana
K
K
Uraguchi
A
A
Ooryoji
Y
Y
Higa
T
T
Kinoshita
K
K
Kosuga
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D016122:Brachiocephalic Trunk; D002560:Cerebrovascular Circulation; D005069:Evaluation Studies as Topic; D005112:Extracorporeal Circulation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion