Innovative technique to treat acute cerebral and peripheral malperfusion during type A aortic dissection repair.
Cerebral and/or visceral malperfusion during CPB is a potentially dramatic situation which can be easily misunderstood if a complete monitoring of arterial pressure and cerebral saturation is not available. Here we present a case in which we could promptly diagnose cerebral and visceral malperfusion just after starting cardiopulmonary bypass. Use of an original and unusual method for distal perfusion allowed us to treat malperfusion, uneventful cooling of the patient down to deep hypothermia and to complete the procedure in circulatory arrest as planned.
Totaro
Pasquale
P
Cardiac Surgery, Civic Hospital, 25123 Brescia, Italy. ptotaro@yahoo.com
Argano
Vincenzo
V
D000208:Acute Disease; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002560:Cerebrovascular Circulation / Q000502:physiology; D006225:Hand / Q000098:blood supply; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017534:Radial Artery; D012039:Regional Blood Flow / Q000502:physiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods