Deep hypothermic circulatory arrest with and without retrograde cerebral perfusion.
Our study indicated that RCP provided significant protection against both postoperative strokes and early death. However, in the subjects studied, the combined detrimental effects of postoperative stroke, COPD, cardiac complications, and procedures requiring composite valve replacement outweighed the protective benefit afforded by RCP in the prevention of early death. RCP's protective benefit was also diminished in the presence of pre-existing cerebrovascular disease. Although the major factors leading to the incidence of postoperative stroke and early mortality were the etiologies and pathologies brought to the operating theater by the patient, RCP when used in conjunction with DHCA significantly diminished the likelihood of either outcome. Therefore, given its simplicity of application in the surgical repair of aortic arch abnormalities, its indication seems warranted.
Raskin
S A
SA
Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Fuselier
V W
VW
Reeves-Viets
J L
JL
Coselli
J S
JS
D001013:Aorta, Thoracic / Q000002:abnormalities / Q000601:surgery; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000503:physiopathology / Q000517:prevention & control; D006324:Heart Arrest, Induced; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007036:Hypothermia, Induced; D008173:Lung Diseases, Obstructive / Q000503:physiopathology; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome