Cerebral perfusion.
Aortic arch surgery necessitates interrupted brain perfusion and carries a risk of brain injury. Various brain protective techniques have been advocated to reduce risk including hypothermic arrest and retrograde or selective antegrade perfusion. Knowledge of the pathophysiologic consequences of deep hypothermia, may aid the surgeon in deciding when to initiate circulatory arrest and for how long. Retrograde cerebral perfusion use was advocated to prolong safe arrest durations but may not improve outcomes. Selective antegrade cerebral perfusion appears to have become the preferred method of brain protection. However, the delivery conditions and optimal perfusate constitution require further study.
Harrington
Deborah K
DK
Department of Cardiac Surgery, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham, United Kingdom.
Fragomeni
Fernanda
F
Bonser
Robert Stuart
RS
D001013:Aorta, Thoracic / Q000601:surgery*; D001366:Axillary Artery; D001921:Brain / Q000098:blood supply*; D002404:Catheterization; D006324:Heart Arrest, Induced; D006400:Hematocrit; D006801:Humans; D007036:Hypothermia, Induced; D008991:Monitoring, Physiologic; D010477:Perfusion / Q000379:methods*; D014656:Vascular Surgical Procedures