Problems of brain protection in aortic arch operations
Malashenkov, A.I.; Rusanov, N.I.; Bykova, V.A.; Rychin, S.V.; Aĭteliev, A.E.; Iakovlev, S.E.; Imaev, T.E.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk 2005(4): 21-25
2005
ISSN/ISBN: 0869-6047 PMID: 15909827 Document Number: 594210
33 patients (25 men and 8 women, aged 18 to 69 years, mean age 47 +/- 12.3 years), underwent ascending aorta and aortic arch replacement. During arch replacement the authors used tile following brain protection methods: profound hypothermic circulatory arrest - in 4 (12.1%) patients, retrograde brain perfusion via Superior vena cava in 11 (33.3%), antegrade perfusion via brachycephalic vessels - in 18 (54.6%) patients. Pharmacological brain protection was applied in all cases as an addition to the listed techniques. 14 (45%) patients underwent partial aortic arch replacement; in 19 (57.6%) patients total aortic arch replacement was performed, including "elephant trunk" distal anastomosis in 4 cases.Hospital mortality rate in patients who underwent operations on the aortic arch was 18.1% (6 patients). Postoperative neurological disorders, Such as transient dysfunction, were observed in 8 (24%) patients; cerebral strokes or intractable neurological disorders were not recorded.The choice of a brain protection method is determined by the extent of the operation and necessary circulation arrest time.