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An Assessment of Selective Cerebral Perfusion Via the Innominate Artery in Aortic Arch Replacement
| Content Provider | Scilit |
|---|---|
| Author | Wozniak, G. Dapper, F. Schindler, E. Akintürk, H. Zickmann, B. Gehron, J. |
| Editor | Hehrlein, F. W. |
| Copyright Year | 1998 |
| Description | Maintaining an adequate cerebral oxygen supply is a serious problem in aortic arch surgery. Deep hypothermic circulatory arrest is the most common method used for cerebral protection, but guarantees only a time-limited safety period. Based on experimental investigations, we applied selective cerebral perfusion via the innominate artery alone with only moderate hypothermia (28°C) and without circulatory arrest in 25 consecutive patients undergoing surgical treatment of an aneurysm(n = 10) or acute type-A dissection (n = 15) involving the aortic valve and arch. In every case a test perfusion was carried out to assess whether the cerebral perfusion achieved would be adequate for the whole Operation. In no case was the perfusion inadequate. As a new perioperative monitoring System, we used computer-aided topographical electroencephalometry (CATEEM).There were 18 male and 7 female patients, their age was 47.0 ± 15.1 years (mean ± SD). Mean time periods were 155.1 ± 37.3 min for aortic cross-clamping, and 69.3 ± 35 min for selective cerebral perfusion. Postoperatively, two patients (8%) revealed a temporary left-sided hemiparesis, and 4 patients (16 %) died within 30 days. The overall mortality rate was 16% in a follow-up period of 24.2 ± 9.5 months. In this small group the CATEEM monitoring enabled an intraoperative selection of patients with sufficient bihemispheric collateral circulation and therefore suitable for simple innominate artery perfusion. |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-2007-1010176.pdf |
| ISSN | 01716425 |
| e-ISSN | 14391902 |
| DOI | 10.1055/s-2007-1010176 |
| Journal | The Thoracic and Cardiovascular Surgeon |
| Issue Number | 01 |
| Volume Number | 46 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 1998-02-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Thoracic and Cardiovascular Surgeon Selective Cerebral Perfusion Innominate Artery Aortic Arch Surgery Computer-aided Topographical Electroencephalometry |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
