title: Direct reperfusion of the right common carotid artery prior to cardiopulmonary bypass in patients with brain malperfusion complicated with acute aortic dissection.
abstract: The cases of 3 patients with brain malperfusion secondary to acute aortic dissection who underwent preoperative perfusion of the right common carotid artery are presented. The patients were 64, 65 and 72 years old and 2 were female. All were in a comatose or semi-comatose state with left hemiplegia. The right common carotid artery was exposed and directly cannulated, using a 12-Fr paediatric arterial cannula. The right common femoral artery was chosen for arterial drainage, using a 14-Fr double-lumen cannula. The circuit contained a small roller pump and heat exchanger coil. Target flow was set at 90 ml/min and blood temperature at 30 °C. Durations of right carotid perfusion were 120, 100 and 45 min, respectively. All underwent partial arch replacement and survived. Postoperative neurological sequelae were minimal in all cases.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Postgraduate School of Medicine, Kobe, Japan yokita@med.kobe-u.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Postgraduate School of Medicine, Kobe, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Matsumori
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Postgraduate School of Medicine, Kobe, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kano
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D017536:Carotid Artery, Common / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015424:Reperfusion / Q000379:methods*
keywords: Acute aortic dissection; Carotid perfusion; Organ malperfusuion