Usefulness of transcranial color Doppler ultrasonography in aortic arch surgery.
BACKGROUND
Hypothermia in combination with selective cerebral perfusion is a well-documented technique for cerebral protection during aortic arch surgery. However, such complex surgery is still accompanied by a considerable incidence of neurological events.


OBJECTIVE
This study describes the advantages of transcranial color Doppler ultrasound (TCDU) as a noninvasive real-time method for intraoperative monitoring of cerebral blood flow.


METHODS
Between 1 January 2010 and 31 December 2011, 29 consecutive patients underwent transcranial echo color Doppler (TCDU) monitoring during hypothermic circulatory arrest.


CONCLUSIONS
TCDU was easily applied and provided continuous information on cerebral perfusion in all patients studied. Early detection of perfusion abnormalities during selective cerebral perfusion guided surgeon and anesthesiologist to research for causes and correct them, avoiding severe neurological consequences. Moreover, transcranial echo color Doppler allowed us to optimize anterograde and retrograde cerebral perfusion rate, avoiding hyper-perfusion or hypo-perfusion phenomena during cardiac arrest.
Cardiovascular Anesthesia and Intensive Care, Alessandro Manzoni Hospital of Lecco, Italy. emanuele.catena@tin.it
Emanuele
E
Catena
Giordano
G
Tasca
Giulia
G
Fracasso
Antonio
A
Toscano
Maria
M
Bonacina
Tulika
T
Narang
Andrea
A
Galanti
Michele
M
Triggiani
Giovanni
G
Lorenzi
Amando
A
Gamba
D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006324:Heart Arrest, Induced / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009422:Nervous System Diseases / Q000209:etiology / Q000517:prevention & control; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging; D010477:Perfusion / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*