Proximal aortic perfusion with passive cerebral flow: a method to prevent cerebral embolism in the arch and descending aortic operation.
Antegrade aortic perfusion is preferable in arch and descending aortic operations. We describe a left lateral approach using an ascending aortic cannula, temporarily relocated within the distal aorta to maintain hypothermic cardiopulmonary bypass of the lower torso. This modification provides continual antegrade systemic perfusion and passive retrograde cerebral flow during arch repair. It minimizes the risk of embolization into the brachiocephalic arteries of debris and malperfusion of the dissected aorta.
Katsumata
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T
Department of Cardiac Surgery, Oxford Heart Centre, The John Radcliffe Hospital, Headington, England. katsu@westaby-heart-oxford.org.uk
Westaby
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S
D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D006801:Humans; D007036:Hypothermia, Induced; D020766:Intracranial Embolism / Q000517:prevention & control*; D010477:Perfusion / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*