Hypothermic circulatory arrest during ascending and aortic arch surgery: the theoretical impact of different cerebral perfusion techniques and other methods of cerebral protection.
Operations on the thoracic aorta using hypothermic circulatory arrest are still associated with significant morbidity and mortality due to neurological complications. During the last decades, different cerebral protection techniques have been introduced into clinical practice to reduce the incidence of such complications. Furthermore clinical as well as basic researches have been performed to improve the outcome after these operations. Currently different cerebral perfusion methods are in clinical use and the superiority of one or the other method is a matter of controversial discussion. This review has been undertaken to evaluate the theoretical impact of these different methods of cerebral protection. Based on the experience of the authors the pros and cons are discussed with clinical and experimental reports from the literature.
Hagl
Christian
C
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. hagl@thg.mh-hannover.de
Khaladj
Nawid
N
Karck
Matthias
M
Kallenbach
Klaus
K
Leyh
Rainer
R
Winterhalter
Michael
M
Haverich
Axel
A
D001011:Aorta / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods; D010477:Perfusion / Q000379:methods