Application of retrograde cerebral perfusion via superior vena cava with deep hypothermic circulatory arrest ;in aortic arch operation
YAO Hao
SHAO Jun
YU Wen-da
GENG Zhi
SONG Ya-jun
LI Qing-guo
Abstract：Objective To sum up the experience on retrograde cerebral perfusion applied in aortic arch operation. Methods The patients with aortic aneurysm and DeBakey type I aortic dissection (n=45, male 35, female 10, aged from 23 to 81 and average age=46.7±13.1) were chosen from Jan. 2014 to Aug. 2015, and given the treatment of retrograde cerebral perfusion via superior vena cava (SVC) with deep hypothermic circulatory arrest (DHCA). Results The time of cardiopulmonary bypass (CPB) was 127 min~314 min (168.1±53.7), time of myocardial devascularization was 66 min~201 min (122.4±31.8), DHCA time was 15 min~53 min (24.4±11.5), time of cerebral perfusion via SVC was 13 min~47 min (28.7±13.2), and the lowest nasopharynx temperature was 14.1℃~22.3 ℃ (17.5±3.0) and the lowest anal temperature was 18.5℃~25.8℃(20.9±2.5) during DHCA. After aortic artery was opened, there were 39 cases of auto-rebeat of heart and 6 of rebeat by electric defibrillation. All patients woke up completely within 1 h to 48 h after the operation. There were 2 cases died and the cause was related to multiple organs failure while not to retrograde cerebral perfusion via SVC. The complications after the operation included renal failure in 1 case, re-thoratomy for hemaostsis in 1 case, stroke in 1 case and transitional disorders of nervous system in 4 cases. Other patients were cured and discharged from hospital. Conclusion The method of retrograde cerebral perfusion via SVC is applied during aortic arch operation can protect brain, simplify the procedure, supply sufficient blood perfusion for brain and prolong the safe period significantly.
Keywords：Retrograde cerebral perfusion via superior vena cavaAortic arch operationCardiopulmonary bypass
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 773-775,779 )