Effects of different cerebral perfusion methods on neurological complications in aortic arch surgery

Wang Jinhong; Yang Feng; Wang Xiaomeng; Hei Feilong

doi:10.3760/j.issn.1673-4777.2024.12.002

Abstract：Objective To evaluate the effects of different cerebral perfusion methods on neurological complications during cardiopulmonary bypass in aortic arch surgery.Methods The clinical data of 241 patients who underwent aortic arch surgery in Beijing Anzhen Hospital,Capital Medical University from July 2019 to May 2022 were retrospectively analyzed.According to different cerebral perfusion methods,they were divided into bilateral cerebral perfusion group and unilateral cerebral perfusion group.The operation conditions,30-day in-hospital mortality and incidence of neurological complications were compared between the two groups.Results A total of 119 patients with mild hypothermic circulatory arrest combined with bilateral antegrade cerebral perfusion(bilateral cerebral perfusion group)and 122 patients with moderate hypothermic circulatory arrest combined with unilateral antegrade cerebral perfusion(unilateral cerebral perfusion group)were enrolled in this study.The duration of cardiopulmonary bypass was longer in the unilateral cerebral perfusion group than that in the bilateral cerebral perfusion group[187(155,207)min vs 176(143,198)min],and cerebral perfusion flow,minimum intraoperative temperature,and perioperative plasma consumption were lower in the bilateral cerebral perfusion group[6(5,7)ml/(kg·min)vs 8(7,10)ml/(kg·min),25(24,25)℃ vs 28(27,30)℃,0(0,400)ml vs 0(0,400)ml](all P＜0.05).There was no significant difference in 30-day in-hospital mortality between the two groups(P=0.168).There was no significant difference in the incidence of permanent neurological complications and temporary neurological compli-cations between the two groups(P=0.951,0.843).Conclusion In aortic arch surgery,unilateral cerebral perfusion and bilateral cerebral perfusion have no effect on the incidence of neurological complications,but bilateral cerebral perfusion can tolerate higher temperature and reduce cardiopulmonary bypass time.