title: Is it safe to initiate selective cerebral perfusion with normothermia?
abstract: OBJECTIVE
  Preceding selective cerebral perfusion (P-SCP) is a method whereby SCP and systemic perfusion start simultaneously, and the arch vessels are clamped. Cerebral circulation is isolated from systemic circulation to avoid cerebral embolization due to detachment of atherosclerotic material from the aorta, caused by the "sandblasting" effect of high-velocity jets of blood exiting the aortic cannula. However, neither the safety of SCP at normothermia nor the influence of extended SCP time has been sufficiently clarified. To clarify the safety of P-SCP, the comparison study of P-SCP and conventional SCP (C-SCP) was performed retrospectively.
  
  
  METHODS
  Fifty-seven patients (C-SCP group: 29 patients; P-SCP: 28 patients) underwent surgery between 1992 and 2002.
  
  
  RESULTS
  Nine (15.8%) in-hospital death occurred; 4 in the C-SCP group (13.8%) and 5 in the P-SCP group (17.9%) (NS). The SCP time was 136.6 +/- 68.5 minutes in the C-SCP group and 195.8 +/- 30.7 minutes in the P-SCP group (p < 0.05). One patient in each group exhibited postoperative neurological dysfunction.
  
  
  CONCLUSIONS
  It may be little dangerous to initiate the SCP with normothermia. P-SCP may be useful in cases in which there is pedunculated atherosclerotic material, or mural thrombus in the ascending and arch aorta.
authors.affiliation: Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. imamaki-cuh@umin.ac.jp
authors.forename: Mizuho
authors.initials: M
authors.lastname: Imamaki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Nakajima
authors.forename: Masahisa
authors.initials: M
authors.lastname: Masuda
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ishida
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shimura
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001831:Body Temperature; D002315:Cardiopulmonary Bypass; D002560:Cerebrovascular Circulation; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D020766:Intracranial Embolism / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010477:Perfusion