title: Perfusion pressure does not affect neurologic outcome in axillary artery side graft cannulation in type a aortic dissection.
abstract: OBJECTIVE
  Antegrade selective cerebral perfusion (ASCP) through the right axillary is a safe and effective method for cerebral protection in aortic surgery. In the present study, we evaluated whether or not pressure control in ASCP affected the neurologic outcome.
  
  
  METHODS
  Sixty-two patients (17 female, 45 male) with a mean age of 53.9 +/- 9.4 years (range, 23-74 years) with a diagnosis of Type A aortic dissection were operated on by using the right axillary artery side graft cannulation technique. ASCP with pressure control was used in the first 37 (59.6%) patients (group 1), whereas ASCP with flow control was used in the consecutive 25 patients (39.4%) (group 2). The groups were compared according to postoperative neurologic outcomes.
  
  
  RESULTS
  The hospital mortality rate was 9.7% with 6 patients. The mean ASCP flows of group 1 was 663 +/- 76 mL/min and 692 +/- 51 mL/min in group 2. This difference was not statistically significant (P = .120). The neurological dysfunction rates were 2.7% in group 1 with 1 patient and 8% in group 2 with 2 patients (P = .560).
  
  
  CONCLUSIONS
  In this study, we could not find a statistically significant difference in patients treated with ASCP through the right axillary applicated with pressure control versus flow control.
authors.affiliation: Department of Cardiovascular Surgery, Ataturk Training and Research Hospital, Izmir, Turkey. bilginemrecan@yahoo.com
authors.forename: Bilgin
authors.initials: B
authors.lastname: Emrecan
authors.forename: Levent
authors.initials: L
authors.lastname: Yilik
authors.forename: Engin
authors.initials: E
authors.lastname: Tulukoglu
authors.forename: Ali
authors.initials: A
authors.lastname: Gürbüz
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D001366:Axillary Artery / Q000637:transplantation*; D002404:Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D010477:Perfusion / Q000009:adverse effects / Q000379:methods; D011312:Pressure; D016896:Treatment Outcome