Modified Technique for Retrograde Cerebral Perfusion during Hemiarch Aortic Replacement
Abstract: Background Uncertainty remains regarding the optimal method of brain protection for procedures that require repair or replacement of the aortic arch. We examined the early outcomes of a technique for brain protection in patients undergoing partial aortic arch (hemiarch) replacement that involves deep hypothermic circulatory arrest (DHCA) and retrograde cerebral perfusion (RCP) of cold blood from the superior vena cava toward the end of the arrest interval. Methods During a recent 15-year interval, 520 patients underwent elective or urgent/emergent ascending aortic and hemiarch replacement as an isolated (47 patients) or combined (473 patients) procedure employing DHCA (mean nasopharyngeal temperature at circulatory arrest, 17.1°C and mean duration, 19.3 minutes) supplemented with RCP of cold blood from the superior vena cava toward the end of the arrest interval (mean, 6.7 minutes). The mean age of the patients was 59.5 years, and 65% were male. Results The in-hospital and 30-day mortality rates were 1.2% (six patients). Seven patients (1.4%) sustained a stroke and 19 patients (3.7%) had transient neurologic dysfunction that completely resolved by the time of hospital discharge. Four patients (0.77%) developed postoperative renal failure requiring dialysis. Twenty-one patients (4%) required ventilator support for >48 hours and five patients (0.96%) required a tracheostomy. The median hospital length of stay was 6 days. Conclusion DHCA with a brief interval of RCP is a safe and effective technique for brain protection during hemiarch aortic replacement. RCP reduces the duration of brain ischemia and permits removal of particulate matter and air from the arterial circulation.
- Location
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Deutsche Nationalbibliothek Frankfurt am Main
- Extent
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Online-Ressource
- Language
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Englisch
- Bibliographic citation
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Modified Technique for Retrograde Cerebral Perfusion during Hemiarch Aortic Replacement ; volume:09 ; number:03 ; year:2021 ; pages:100-105
AORTA ; 09, Heft 03 (2021), 100-105
- Contributor
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Kouchoukos, Nicholas T.
Haynes, Marc
Hester, Sarah
Castner, Catherine F.
- DOI
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10.1055/s-0041-1726279
- URN
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urn:nbn:de:101:1-2022031909353276383458
- Rights
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Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Last update
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15.08.2025, 7:39 AM CEST
Data provider
Deutsche Nationalbibliothek. If you have any questions about the object, please contact the data provider.
Associated
- Kouchoukos, Nicholas T.
- Haynes, Marc
- Hester, Sarah
- Castner, Catherine F.
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Selective cerebral perfusion with 4-branch graft total aortic arch replacement: Outcomes in 12 patients
Evaluation of cerebral circulation during retrograde perfusion by laser speckle flowgraphy
Direct Innominate Artery Cannulation versus Side Graft for Selective Antegrade Cerebral Perfusion during Aortic Hemiarch Replacement
Retrograde cerebral perfusion reduces embolic and watershed lesions after acute type a aortic dissection repair with deep hypothermic circulatory arrest
Retrograde Inferior Vena caval Perfusion for Total Aortic arch Replacement Surgery (RIVP-TARS): study protocol for a multicenter, randomized controlled trial
Konservierung von Hundenebennieren durch retrograde Perfusion
Different hypothermic and cerebral perfusion strategies in extended arch replacement for acute type a aortic dissection: a retrospective comparative study
Effect of aortic valve replacement on myocardial perfusion and exercise capacity in patients with severe aortic stenosis
Right axillary and femoral artery perfusion with mild hypothermia for aortic arch replacement
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Total aortic arch replacement under intermittent pressure-augmented retrograde cerebral perfusion
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Selective cerebral perfusion with 4-branch graft total aortic arch replacement: Outcomes in 12 patients
Evaluation of cerebral circulation during retrograde perfusion by laser speckle flowgraphy
Direct Innominate Artery Cannulation versus Side Graft for Selective Antegrade Cerebral Perfusion during Aortic Hemiarch Replacement
Retrograde cerebral perfusion reduces embolic and watershed lesions after acute type a aortic dissection repair with deep hypothermic circulatory arrest
Retrograde Inferior Vena caval Perfusion for Total Aortic arch Replacement Surgery (RIVP-TARS): study protocol for a multicenter, randomized controlled trial
Konservierung von Hundenebennieren durch retrograde Perfusion
Different hypothermic and cerebral perfusion strategies in extended arch replacement for acute type a aortic dissection: a retrospective comparative study
Effect of aortic valve replacement on myocardial perfusion and exercise capacity in patients with severe aortic stenosis
Right axillary and femoral artery perfusion with mild hypothermia for aortic arch replacement