• Ann Thorac Cardiovasc Surg · Feb 2001

    Review

    Cerebral protection during surgery for aortic arch aneurysms.

    • H Otani and H Imamura.
    • Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8507, Japan.
    • Ann Thorac Cardiovasc Surg. 2001 Feb 1;7(1):4-10.

    AbstractSurgical repair of aneurysms or dissections involving the transverse aortic arch and the distal aortic arch carries a considerable risk of cerebral complications. Currently, deep hypothermic circulatory arrest (DHCA), moderate hypothermic circulatory arrest or DHCA with selective cerebral perfusion (SCP) and DHCA with retrograde cerebral perfusion (RCP) are used as means to protect the central nervous system. DHCA alone is simple, but the safe time of DHCA is limited. RCP is an alternative technique for cerebral protection that can prolong the safe time of DHCA. SCP offers virtually unlimited time in isolating cerebral circulation. With the improvement of cardiopulmonary bypass (CPB) materials and myocardial preservation, DHCA with SCP is our current preference of an adjunct for cerebral protection, although possible increment of mortality and morbidity associated with a prolonged DHCA and CPB remains to be overcome.

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