Journal of cardiac surgery
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Aortic arch surgery is impossible without the temporary interruption of brain perfusion and therefore is associated with high incidence of neurologic injury. The deep hypothermic circulatory arrest (HCA), in combination with antegrade or retrograde cerebral perfusion (RCP), is a well-established method of brain protection in aortic arch surgery. In this retrospective study, we compare the two methods of brain perfusion. ⋯ The antegrade perfusion seems to be related with significantly lower incidence of temporary neurological complications, earlier extubation, shorter ICU-stay, and hospitalization, and hence lower total cost.
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Case Reports
The use of intraoperative Doppler assessment to guide the surgical treatment of anomalous right coronary arteries.
Despite its rarity, anomalous origin of the right coronary artery (RCA) from the left coronary sinus can pose risk of sudden death. Because of this risk, many patients elect surgical correction of this anomaly. Surgical strategies for correction of this include ostioplasty, coronary artery reimplantation, and, more commonly, coronary artery bypass grafting. ⋯ In each case, the RCA was bypassed using a saphenous vein graft (SVG) that was used to bypass origin of the RCA. Flow through the graft was compared with and without ligation of the proximal RCA, before creation of the proximal anastomosis. In each case, flow through the SVG was not significantly reduced with the proximal RCA patent and ligation was not performed.