Cerebral microembolization during antegrade selective cerebral perfusion.
BACKGROUND
This study quantified the number of intraoperative microemboli in patients undergoing aortic arch surgery using selective cerebral perfusion (SCP) in comparison with those in patients undergoing ascending aortic replacement without circulatory arrest and SCP.


METHODS
A transcranial Doppler monitoring of the medial cerebral artery was performed in 15 patients undergoing proximal arch replacement with SCP (SCP group) and 15 patients undergoing replacement of the ascending aorta (control group).


RESULTS
There was no significant difference in the high-intensity transient signal counts between the SCP group and the control group at any phase. In the SCP group, 4.8% of microemboli occurred during cross-clamping, and only 0.6% occurred during SCP. In the control group, 4.6% occurred during cross-clamping. Most microemboli occurred after removing the cross-clamps in both groups; 92.2% in the SCP group and 92.1% in the control group.


CONCLUSIONS
The present study demonstrated that outbreak frequency of microemboli during SCP was very low, and thus implies that the risk of embolic event that may be caused by SCP is very low.
Kamiya
Hiroyuki
H
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany. hkamiya88@yahoo.co.jp
Klima
Uwe
U
Hagl
Christian
C
Logemann
Frank
F
Winterhalter
Michael
M
Shrestha
Malakh L
ML
Kallenbach
Klaus
K
Khaladj
Nawid
N
Haverich
Axel
A
Karck
Matthias
M
D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001921:Brain / Q000098:blood supply*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D018570:Risk Assessment; D017585:Ultrasonography, Doppler, Transcranial