Journal of cardiac surgery
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Comparative Study
Aortic arch reconstruction: safety of moderate hypothermia and antegrade cerebral perfusion during systemic circulatory arrest.
The ideal strategy for cerebral protection during aortic arch (AA) reconstructive surgery remains undefined. Antegrade cerebral perfusion (ACP) during systemic circulatory arrest (SCA) may provide superior results; however, optimal systemic temperature is undetermined. Our objective was to determine whether "deep" hypothermia is necessary during ACP with SCA, and whether the degree of hypothermia is associated with neurologic outcomes postoperatively. ⋯ In our experience, SCA with ACP was a safe technique for AA reconstructive surgery. The observation of a larger number of major neurologic injuries, and a trend toward a higher incidence of delirium in the <22 degrees C group, suggests that systemic temperatures below 22 degrees C may not be necessary and may be associated with a higher incidence of neurologic injury when using ACP during SCA.
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Comparative Study
A simple technique of distal limb perfusion during prolonged femoro-femoral cannulation.
Cannulation of the femoral vessels for cardiopulmonary support is a common approach for many cardiac procedures as well as access of choice for many emergency bypass systems such as extracorporeal membrane oxygenation. A serious complication of prolonged femoral cannulation remains the ischemic injury of the distal limb. ⋯ This technique of distal limb perfusion was found to be safe and effective in preventing lower limb ischemia for patients with prolonged femoral cannulation for extracorporeal circulatory support.